How well do clinic-based blood pressure measurements agree with the mercury standard?

Journal Article (Journal Article)

BACKGROUND: Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP measurement. OBJECTIVE: To examine agreement between real-time clinic-based assessment of BP and the standard mercury assessment of BP. DESIGN: Prospective reliability study. PATIENTS: One hundred patients with an International Classification of Diseases-9th edition code for hypertension were enrolled. MEASURES: Two BP measurements were obtained with the Hawksley random-zero mercury sphygmomanometer and averaged. The clinic-based BP was extracted from the computerized medical records. RESULTS: Agreement between the mercury and clinic-based systolic blood pressure (SBP) was good, intraclass correlation coefficient (ICC)=0.91 (95% confidence interval (CI): 0.83 to 0.94); the agreement for the mercury and clinic-based diastolic blood pressure (DBP) was satisfactory, ICC=0.77 (95% CI: 0.62 to 0.86). Overall, clinic-based readings overestimated the mercury readings, with a mean overestimation of 8.3 mmHg for SBP and 7.1 mmHg for DBP. Based on the clinic-based measure, 21% of patients were misdiagnosed with uncontrolled hypertension. CONCLUSIONS: Health professionals should be aware of this potential difference when utilizing clinic-based BP values for making treatment decisions and/or assessing quality of care.

Full Text

Duke Authors

Cited Authors

  • Kim, JW; Bosworth, HB; Voils, CI; Olsen, M; Dudley, T; Gribbin, M; Adams, M; Oddone, EZ

Published Date

  • July 2005

Published In

Volume / Issue

  • 20 / 7

Start / End Page

  • 647 - 649

PubMed ID

  • 16050862

Pubmed Central ID

  • PMC1490157

Electronic International Standard Serial Number (EISSN)

  • 1525-1497

Digital Object Identifier (DOI)

  • 10.1111/j.1525-1497.2005.0105.x


  • eng

Conference Location

  • United States