Recommended Standards For Assessing Blood Pressure in Human Research Where Blood Pressure Or Hypertension Is A Major Focus - Recommended Standards For Assessing Blood Pressure in Human Research Where Blood Pressure Or Hypertension Is A Major Focus - Open Access Pub

Although inaccurate, non-reproducible blood pressure values can result from non-standardized assessments, recommended approaches to standardize blood pressure measurement are often not followed in research studies. An expert consensus of national and international health and scientific organizations developed recommended minimum standards for assessing blood pressure in research subjects where: 1) blood pressure or hypertension is a major endpoint, or 2) blood pressure is likely a major mediator of the research outcome. Minimum research standards are presented for training of observers, technical aspects of assessing blood pressure, and equipment for both adults and children. The standards are based on prior recommendations some of which did not conform to current evidence based methods. All new research should require adherence to these minimum standards on the patient populations described above. Readers need to use caution in interpreting studies if the standards are not met in the defined populations. DOI10.14302/issn.2329-9487.jhc-16-1338 Standardized and rigorous methods for blood pressure measurement are necessary to ensure the comparability and accuracy of blood pressure assessments for individuals due to the effects of measurement error, diurnal variation and short- and long-term variability 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. Many studies have demonstrated substantive changes in blood pressure related to methodological issues when the blood pressure assessment did not satisfy the established standards 6, 8, 11, 12, 13. It is thought that a lack of rigor/standardization in assessing blood pressure may reduce or mask the relationship between blood pressure, lifestyle changes or antihypertensive medications and adverse outcomes. For example, the INTERHEART study assessed blood pressure status solely by asking participants if they had been diagnosed with hypertension in many countries where awareness of hypertension diagnosis was low 14. Not surprisingly, the INTERHEART study found hypertension to be the 6th leading risk for acute myocardial infarction, while based on numerous studies, there is a consensus that increased blood pressure is the leading risk for ischemic heart disease 15. The INTERHEART findings could mislead policy makers that hypertension control is not as high a priority intervention as interventions on risks that ranked higher. Further, observations of non-blood pressure lowering effects of antihypertensive drugs may be attributed to inadequate assessment of blood pressure or inadequate assessment of BP could limit the ability to