Key result
The second systolic blood pressure measurement was significantly lower than the first by a mean of 4.3 mm Hg (p < 0.001) during preventive workplace examinations.
Why the study?
Evidence showing blood pressure variation during a medical visit was limited, with current recommendations largely based on expert opinion.
Does a second blood pressure measurement significantly differ from the first and alter hypertension diagnosis in non-hypertensive patients during a preventive examination?
Cross-Sectional (n=52)
No
Does a second blood pressure measurement significantly differ from the first and alter hypertension diagnosis in non-hypertensive patients during a preventive examination?
Mean Difference: -4.3
Absolute Event Rate: 138.1% vs 142.4%
p-value: p=<0.001
A second blood pressure measurement taken one minute after the first during a preventive examination is significantly lower, highlighting the importance of multiple readings to avoid overdiagnosing hypertension.
Initial office BP readings may vary enough to affect diagnosis; leaves open standardization of measurement protocols.
Background: Despite advantages of ambulatory and home blood pressure monitoring, office blood pressure measurement remains the principal method for the diagnosis and management of hypertension. There still seems to be too little evidence to date showing variation in blood pressure during a medical visit and the current recommendations are mainly based on expert’s opinions. The aim of this study was to evaluate the difference between the first two blood pressure measurements performed during a preventive examination and to verify whether the second measurement could influence clinical decisions in non-hypertensive patients. Material and methods: The study included 52 consecutive patients without history of hypertension or other cardiovascular diseases. Blood pressure and heart rate (HR) were measured twice, the first reading after 5 minutes rest and the second 1 minute later. Results: Significant differences were found between the first (fBPM) and second (sBPM) blood pressure measurements, both systolic blood pressure (SBP) 142.4 mm Hg [interquartile range (IQR): 130.8–152.0] vs. 138.1 mm Hg (IQR: 125.8–149.5), p < 0.001 and diastolic blood pressure (DBP) 85.8 mm Hg (IQR: 80.0–91.5) vs. 83.9 mm Hg (IQR: 77.0–90.3), p < 0.001, and heart rate (HR) 73.1/min (IQR: 64.8–80.0) vs. 71.8/min (IQR: 64.8–77.3), p < 0.001. In 63.5% of the participants, the difference between the measurements was over 5 mm Hg for SBP values and in 23.1% of the participants for DBP values. According to fBPM, 53.8% of the patients met the criteria for the diagnosis of hypertension and according to sBPM 48.1% (NS). Conclusion: We demonstrated substantial discrepancies between blood pressure values taken during the first and the second preventive medical check-up visit performed in the workplace. Preventive examination in the workspace is associated with similar number of false-positive results when hypertension status is evaluated as compared to regular office visits.
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Artyszuk et al. (2023) conducted a cross-sectional in No history of hypertension or cardiovascular disease (n=52). Second blood pressure measurement (sBPM) vs. First blood pressure measurement (fBPM) was evaluated on Systolic blood pressure (SBP) (MD -4.3 mm Hg, p=<0.001). The second systolic blood pressure measurement was significantly lower than the first by a mean of 4.3 mm Hg (p < 0.001) during preventive workplace examinations.
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