Who's really hypertensive? - Quality control issues in the assessment of blood pressure for randomized trials

Reid, Christopher M., Ryan, Philip, Miles, Helen, Willson, Kristyn, Beilin, Lawrence J., Brown, Mark A., Jennings, Garry L., Johnston, Collin I., Macdonald, Graham J., Marley, John E., Mcneil, John J., Morgan, Trefor O., West, Malcolm J. and Wing, Lindon M. H. (2005) Who's really hypertensive? - Quality control issues in the assessment of blood pressure for randomized trials. Blood Pressure, 14 3: 133-138. doi:10.1080/08037050510034194

Author Reid, Christopher M.
Ryan, Philip
Miles, Helen
Willson, Kristyn
Beilin, Lawrence J.
Brown, Mark A.
Jennings, Garry L.
Johnston, Collin I.
Macdonald, Graham J.
Marley, John E.
Mcneil, John J.
Morgan, Trefor O.
West, Malcolm J.
Wing, Lindon M. H.
Title Who's really hypertensive? - Quality control issues in the assessment of blood pressure for randomized trials
Journal name Blood Pressure   Check publisher's open access policy
ISSN 0803-7051
Publication date 2005
Sub-type Article (original research)
DOI 10.1080/08037050510034194
Volume 14
Issue 3
Start page 133
End page 138
Total pages 6
Place of publication Basingstoke, UK
Publisher Taylor & Francis
Collection year 2005
Language eng
Subject C1
11 Medical and Health Sciences
1102 Cardiovascular Medicine and Haematology
Abstract The characterization of blood pressure in treatment trials assessing the benefits of blood pressure lowering regimens is a critical factor for the appropriate interpretation of study results. With numerous operators involved in the measurement of blood pressure in many thousands of patients being screened for entry into clinical trials, it is essential that operators follow pre-defined measurement protocols involving multiple measurements and standardized techniques. Blood pressure measurement protocols have been developed by international societies and emphasize the importance of appropriate choice of cuff size, identification of Korotkoff sounds, and digit preference. Training of operators and auditing of blood pressure measurement may assist in reducing the operator-related errors in measurement. This paper describes the quality control activities adopted for the screening stage of the 2nd Australian National Blood Pressure Study (ANBP2). ANBP2 is cardiovascular outcome trial of the treatment of hypertension in the elderly that was conducted entirely in general practices in Australia. A total of 54 288 subjects were screened; 3688 previously untreated subjects were identified as having blood pressure >140/90 mmHg at the initial screening visit, 898 (24%) were not eligible for study entry after two further visits due to the elevated reading not being sustained. For both systolic and diastolic blood pressure recording, observed digit preference fell within 7 percentage points of the expected frequency. Protocol adherence, in terms of the required minimum blood pressure difference between the last two successive recordings, was 99.8%. These data suggest that adherence to blood pressure recording protocols and elimination of digit preferences can be achieved through appropriate training programs and quality control activities in large multi-centre community-based trials in general practice. Repeated blood pressure measurement prior to initial diagnosis and study entry is essential to appropriately characterize hypertension in these elderly patients.
Keyword Blood Pressure Measurement
Quality Control
Clinical Trials
Peripheral Vascular Disease
Antihypertensive Drug-treatment
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 6 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 10 times in Scopus Article | Citations
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Created: Wed, 15 Aug 2007, 06:03:33 EST