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Vol 23, No 1 (2019)
ORIGINAL PAPERS
Published online: 2018-11-29
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Variability of subsequent blood pressure measurements carried out among adult volunteers

Martyna Schönborn, Agnieszka Trynkiewicz, Małgorzata Cebeńko, Danuta Czarnecka, Agnieszka Olszanecka
DOI: 10.5603/AH.a2018.0021
·
Arterial Hypertension 2019;23(1):22-29.

open access

Vol 23, No 1 (2019)
ORIGINAL PAPERS
Published online: 2018-11-29

Abstract

Background. Arterial hypertension (AH) affects 31% of Polish adult population. However, proper evaluation of
blood pressure (BP) is compromised by the phenomenon of its variability. The purpose of the study was to assess the
variability of subsequent BP measurements and to define its determining factors.

Material and methods. Data were collected among volunteers during World Hypertension Day 2017 in Kraków.
Information about socio-demographic status, cardiovascular risk factors and concomitant diseases were obtained
with use of standardized questionnaires. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate
were measured thrice. The differences between consecutive measurements were analysed.

Results. The study included 419 participants (age 48.7 ± 19.6 years; 56.1% females). The first SBP and DBP measurements were significantly higher than the second and the third one. In multiple regression analysis — age, first BP value and sex were significantly related with BP variability. Elevated BP among subjects without previous history of AH was detected in 119 participants (diagnosis based on the 1st BP reading) and in 79 when diagnosis was based on the average of the 2nd and 3rd measurements.

Conclusions. Consecutive BP measurements are highly variable. These differences are gender-related and the extend
of BP decline is determined significantly by the first BP value. Correct measurement and interpretation of the BP is
essential in the diagnosis and management of AH. The combination of the 2nd and 3rd reading seems to be favourable
over single reading; therefore, multiple BP measurements should be recommended even in screening actions.

Abstract

Background. Arterial hypertension (AH) affects 31% of Polish adult population. However, proper evaluation of
blood pressure (BP) is compromised by the phenomenon of its variability. The purpose of the study was to assess the
variability of subsequent BP measurements and to define its determining factors.

Material and methods. Data were collected among volunteers during World Hypertension Day 2017 in Kraków.
Information about socio-demographic status, cardiovascular risk factors and concomitant diseases were obtained
with use of standardized questionnaires. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate
were measured thrice. The differences between consecutive measurements were analysed.

Results. The study included 419 participants (age 48.7 ± 19.6 years; 56.1% females). The first SBP and DBP measurements were significantly higher than the second and the third one. In multiple regression analysis — age, first BP value and sex were significantly related with BP variability. Elevated BP among subjects without previous history of AH was detected in 119 participants (diagnosis based on the 1st BP reading) and in 79 when diagnosis was based on the average of the 2nd and 3rd measurements.

Conclusions. Consecutive BP measurements are highly variable. These differences are gender-related and the extend
of BP decline is determined significantly by the first BP value. Correct measurement and interpretation of the BP is
essential in the diagnosis and management of AH. The combination of the 2nd and 3rd reading seems to be favourable
over single reading; therefore, multiple BP measurements should be recommended even in screening actions.

Get Citation

Keywords

arterial hypertension; blood pressure measurement; blood pressure variability

About this article
Title

Variability of subsequent blood pressure measurements carried out among adult volunteers

Journal

Arterial Hypertension

Issue

Vol 23, No 1 (2019)

Pages

22-29

Published online

2018-11-29

DOI

10.5603/AH.a2018.0021

Bibliographic record

Arterial Hypertension 2019;23(1):22-29.

Keywords

arterial hypertension
blood pressure measurement
blood pressure variability

Authors

Martyna Schönborn
Agnieszka Trynkiewicz
Małgorzata Cebeńko
Danuta Czarnecka
Agnieszka Olszanecka

References (20)
  1. Lopez AD, Mathers CD, Ezzati M, et al. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006; 367(9524): 1747–1757.
  2. Lewington S, Clarke R, Qizilbash N, et al. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002; 360(9349): 1903–1913.
  3. Zdrojewski T, Rutkowski M, Bandosz P. Ocena rozpowszechnienia i kontroli czynników ryzyka chorób serca i naczyń w Polsce: Badania NATPOL 1997, 2002, 2011. In: Kopeć G, Jankowski P, Pająk A. ed. Epidemiologia i prewencja chorób układu krążenia. Medycyna Praktyczna, Kraków 2015: 57–64.
  4. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021–3104.
  5. Mancia G, Bertinieri G, Grassi G, et al. Effects of blood-pressure measurement by the doctor on patient's blood pressure and heart rate. Lancet. 1983; 2(8352): 695–698.
  6. Schulze MB, Kroke A, Bergmann MM, et al. Differences of blood pressure estimates between consecutive measurements on one occasion: implications for inter-study comparability of epidemiologic studies. Eur J Epidemiol. 2000; 16(10): 891–898.
  7. Wietlisbach V, Rickenbach M, Burnand B, et al. Combining repeated blood pressure measurements to obtain prevalences of high blood pressure. Acta Med Scand Suppl. 1988; 728: 165–168.
  8. Mo R, Lund-Johansen P, Omvik P. [How much is the decrease in blood pressure shown by repeated measurements during the same examination?]. Tidsskr Nor Laegeforen. 1993; 113(2): 214–217.
  9. van Loo JM, Peer PG, Thien TA. Twenty-five minutes between blood pressure readings: the influence on prevalence rates of isolated systolic hypertension. J Hypertens. 1986; 4(5): 631–635.
  10. Jamieson MJ, Webster J, Philips S, et al. The measurement of blood pressure: sitting or supine, once or twice? J Hypertens. 1990; 8(7): 635–640.
  11. Burstyn P, O'Donovan B, Charlton I. Blood pressure variability: the effects of repeated measurement. Postgrad Med J. 1981; 57(670): 488–491.
  12. Tocci G, Presta V, Figliuzzi I, et al. Prevalence and clinical outcomes of white-coat and masked hypertension: Analysis of a large ambulatory blood pressure database. J Clin Hypertens (Greenwich). 2018; 20(2): 297–305.
  13. Johansson JK, Niiranen TJ, Puukka PJ, et al. Factors affecting the variability of home-measured blood pressure and heart rate: the Finn-home study. J Hypertens. 2010; 28(9): 1836–1845.
  14. Veloudi P, Blizzard CL, Srikanth VK, et al. Age-dependent changes in blood pressure over consecutive office measurements: impact on hypertension diagnosis and implications for international guidelines. J Hypertens. 2017; 35(4): 753–760.
  15. Modesti PA, Rapi S, Bamoshmoosh M, et al. Impact of one or two visits strategy on hypertension burden estimation in HYDY, a population-based cross-sectional study: implications for healthcare resource allocation decision making. BMJ Open. 2012; 2(4).
  16. Handler J, Zhao Y, Egan BM. Impact of the number of blood pressure measurements on blood pressure classification in US adults: NHANES 1999-2008. J Clin Hypertens (Greenwich). 2012; 14(11): 751–759.
  17. Mallick S, Kanthety R, Rahman M. Home blood pressure monitoring in clinical practice: a review. Am J Med. 2009; 122(9): 803–810.
  18. Drawz PE, Abdalla M, Rahman M. Blood pressure measurement: clinic, home, ambulatory, and beyond. Am J Kidney Dis. 2012; 60(3): 449–462.
  19. Frattola A, Parati G, Cuspidi C, et al. Prognostic value of 24-hour blood pressure variability. J Hypertens. 1993; 11(10): 1133–1137.
  20. Velasco A, Ayers C, Das SR, et al. Target organ complications and prognostic significance of alerting reaction: analysis from the Dallas Heart Study. J Hypertens. 2016; 34(2): 226–234.

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