Evidence map›Paper›PMID 31034450›Full record

GuidelineJournal of hypertension2019

Optimizing observer performance of clinic blood pressure measurement: a position statement from the Lancet Commission on Hypertension Group.

Raj Padwal, Norm R C Campbell, Aletta E Schutte, Michael Hecht Olsen, Christian Delles, Anthony Etyang, J Kennedy Cruickshank, George Stergiou, Michael K Rakotz, Gregory Wozniak and 4 more

Abstract readPractice Guideline
In one paragraph

Guideline in Journal of hypertension, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
  6. Attention to blood pressure cuff sizes is important for home and in-clinic blood pressure measurement.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. What Constitutes Adequate Control of High Blood Pressure? Current Considerations.Mayo Clinic proceedings. Innovations, quality & outcomes · 2024
    Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Accuracy of cuff blood pressure and systolic blood pressure amplification.Hypertension research : official journal of the Japanese Society of Hypertension · 2023
    Article
  18. Article
  19. Article
  20. Quality is not an act, it is a habit-Aristotle.Hypertension research : official journal of the Japanese Society of Hypertension · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Raj PadwalDepartment of Medicine, University of Alberta, Edmonton.
Norm R C CampbellDepartment of Medicine, Physiology and Pharmacology and Community Health Sciences, O'Brien Institute for Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Aletta E SchutteHypertension in Africa Research Team (HART), MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
Michael Hecht OlsenDepartment of Internal Medicine, Holbaek Hospital, Holbaek.
Christian DellesInstitute of Cardiovascular and Medical Sciences, University of Glasgow, UK.
Anthony EtyangKEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
J Kennedy CruickshankSchool of Life-Course/Nutritional Sciences, King's College, St. Thomas' & Guy's Hospitals, London, UK.
George StergiouHypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
Michael K RakotzAmerican Medical Association, Chicago, Illinois.
Gregory WozniakAmerican Medical Association, Chicago, Illinois.
Marc G JaffeResolve to Save Lives, An Initiative of Vital Strategies, New York, New York.
Ivor BenjaminAmerican Heart Association, Cardiovascular Center, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA.
Gianfranco ParatiDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
James E SharmanMenzies Institute for Medical Research, University of Tasmania, Hobart, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

: High blood pressure (BP) is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. Accurate BP measurement is critical, given that a 5-mmHg measurement error may lead to incorrect hypertension status classification in 84 million individuals worldwide. This position statement summarizes procedures for optimizing observer performance in clinic BP measurement, with special attention given to low-to-middle-income settings, where resource limitations, heavy workloads, time constraints, and lack of electrical power make measurement more challenging. Many measurement errors can be minimized by appropriate patient preparation and standardized techniques. Validated semi-automated/automated upper arm cuff devices should be used instead of auscultation to simplify measurement and prevent observer error. Task sharing, creating a dedicated measurement workstation, and using semi-automated or solar-charged devices may help. Ensuring observer training, and periodic re-training, is critical. Low-cost, easily accessible certification programs should be considered to facilitate best BP measurement practice.

Indexed as

Blood Pressure DeterminationArmAuscultationAutomationBlood PressureHumansHypertension

Identifiers

PMID31034450
PMCPMC6686964

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.