Comparison of different measures of blood pressure

doi:10.1136/bmj.325.7376.1360

BMJ 2002;325:1360 ( 7 December )

Letters

Comparison of different measures of blood pressure

Use sphygmomanometers more, not less

Blood pressure measurement causes problems in clinical practice

Ambulatory blood pressure may not be gold standard

Study was not first or only one

Agreement is not same as correlation

Use sphygmomanometers more, not less

The first 150 words of the full text of this article appear below.

EDITOR $---$ Little et al in their study have shown that doctors' measurements of blood pressure are much higher than those takenby nurses, by the patient at home, or by ambulatory monitoring.¹From this they conclude that conventional measurements by generalpractitioners may be misleading in guiding treatment decisions.We believe, however, that this conclusion runs ahead of theevidence.

The chain of research evidence that is required to make this conclusion has three links. The first link is finding a reliablemethod of measuring blood pressure; the second link is showingthat raised blood pressure diagnosed by the chosen method increasesthe patient's risk of a cardiovascular event; the last link isshowing that treatment reduces the risk. Knowing the absolutebenefits of treatment and what target blood pressure to aim forare valuable parts of the lastlink.

Our concern is that the research evidence for treatment . . . [Full text of this article]

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Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure: Paul Little, Jane Barnett, Lucy Barnsley, Jean Marjoram, Alex Fitzgerald-Barron, and David Mant
BMJ 2002 325: 254. [Abstract] [Full Text] [PDF]