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Comparative Study
. 2016 Jun;10(6):493-9.
doi: 10.1016/j.jash.2016.03.186. Epub 2016 Mar 30.

Prevalence of pseudoresistant hypertension due to inaccurate blood pressure measurement

Hemal Bhatt  1 , Mohammed Siddiqui  2 , Eric Judd  2 , Suzanne Oparil  2 , David Calhoun  2
Affiliations
Comparative Study

Prevalence of pseudoresistant hypertension due to inaccurate blood pressure measurement

Hemal Bhatt et al. J Am Soc Hypertens. 2016 Jun.

Abstract

The prevalence of pseudoresistant hypertension (HTN) due to inaccurate BP measurement remains unknown. Triage BP measurements and measurements obtained at the same clinic visit by trained physicians were compared in consecutive adult patients referred for uncontrolled resistant HTN (RHTN). Triage BP measurements were taken by the clinic staff during normal intake procedures. BP measurements were obtained by trained physicians using the BpTRU (VSM Med Tech Ltd. Coquitlam, Canada) device. The prevalence of uncontrolled RHTN and differences in BP measurements were compared. Of 130 patients with uncontrolled RHTN, 33.1% (n = 43) were falsely identified as having uncontrolled RHTN based on triage BP measurements. The median (inter-quartile range) of differences in systolic BP between pseudoresistant and true resistant groups were 23 (17-33) mm Hg and 13 (6-21) mm Hg, respectively (P = .0001). The median (inter-quartile range) of differences in diastolic BP between the two groups were 12 (7-18) mm Hg and 8 (4-11) mm Hg, respectively (P = .001). Triage BP technique overestimated the prevalence of uncontrolled RHTN in approximately 33% of the patients emphasizing the importance of obtaining accurate BP measurements.

Keywords: Blood pressure; blood pressure measurement technique; pseudoresistant hypertension; resistant hypertension.

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Conflict of interest statement

Disclosures or conflict of interest: None

Figures

Figure 1
Figure 1
Box-Whisker plot of median (inter-quartile range) for differences between triage and expertly obtained blood pressure for pseudoresistant and true resistant groups. Differences in both systolic blood pressure (SBP) and diastolic blood pressures (DBP) reported. *P = 0.0001, ^P = 0.001.
Figure 2
Figure 2
Estimated prevalence (mean, standard deviation) of each of the causes of pseudoresistant hypertension. *references –; ‡ references ,,,; † references ,.
See this image and copyright information in PMC

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