scholarly journals Effect of Terminal Digit Preference on Blood Pressure Measurement and Treatment in Primary Care

2006 ◽  
Vol 19 (2) ◽  
pp. 147-152 ◽  
Author(s):  
P NIETERT ◽  
A WESSELL ◽  
C FEIFER ◽  
S ORNSTEIN
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Digit Preference

Abstract P333: National Trends in the Quality of Office Blood Pressure Measurements, 2014-2019

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Kathryn Foti ◽  
Lawrence J Appel ◽  
Kunihiro Matsushita ◽  
Josef Coresh ◽  
G Caleb Alexander ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Practice ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Pressure Measurements ◽  
Hypertension Treatment ◽  
Digit Preference ◽  
Provider Characteristics ◽  
Over Time

Introduction: Clinical practice guidelines emphasize the importance of accurate blood pressure measurement and recording to diagnose and treat hypertension. Trends in terminal digit preference (typically manifest by a terminal digit of ‘0’) have not been examined nationally. The growing use of automated blood pressure devices may have reduced terminal digit preference and improved accuracy over time. Objective: To evaluate trends in terminal digit preference in office blood pressure measurements among adults with hypertension by patient and provider characteristics. Methods: We used IQVIA National Disease and Therapeutic Index (NDTI) data from January 2014 through June 2019. The NDTI is designed to be nationally-representative of all patient visits to office-based physicians and uses a two-stage stratified sampling design to sample ~4,000 physicians per quarter who report information on all patient visits on 2 random workdays. We included all hypertension treatment visits (~60M/year) among adults aged ≥18. We examined trends in the proportion of hypertension treatment visits with recorded systolic (SBP) and diastolic (DBP) blood pressure measurements with a terminal digit ‘0’. The expected percent of blood pressures with ‘0’ is 10% for automated and 20% for manual readings. Results: There was a decrease in the percent of visits with SBP (43.0% to 37.4%) or DBP (44.3% to 38.1%) recordings ending in zero ( Table ). The decrease in percent of SBPs with a terminal zero was similar by patient and provider characteristics, though the percentage of SBPs with a terminal ‘0’ was consistently higher among patients aged ≥60, when SBP ≥140 mmHg, and among cardiologists. Conclusions: Terminal digit preference is common indicating systematic error in blood pressure measurement and recording, despite some improvement over time. This may lead to under- and overtreatment of patients with hypertension. Improving the quality of blood pressure measurement is central to improving hypertension diagnosis and control in clinical practice.

scholarly journals A bundled quality improvement program to standardize clinical blood pressure measurement in primary care

2017 ◽  
Vol 20 (2) ◽  
pp. 324-333 ◽  
Author(s):  
Romsai T. Boonyasai ◽  
Kathryn A. Carson ◽  
Jill A. Marsteller ◽  
Katherine B. Dietz ◽  
Gary J. Noronha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Clinical Blood Pressure

scholarly journals Inter-Arm Blood Pressure Difference Among Nigerian Primary Care Patients— the Need for Dual Arm Blood Pressure Measurement

2020 ◽  
pp. 1-7
Author(s):  
Oluwaseun Solomon Ojo ◽  
Oluwaseun Solomon Ojo ◽  
Akinfemi Joel Fatusin ◽  
Bolatito Betty Fatusin ◽  
Ademola Oluwaseun Egunjobi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Primary Care ◽  
Pressure Measurement ◽  
Pressure Difference ◽  
Blood Pressure Measurement ◽  
Blood Pressure Difference ◽  
Primary Care Patients ◽  
The Right ◽  
Dual Arm

Background: For many decades, hypertension guidelines have recommended dual-arm blood pressure measurement. However, the practice is poor in Nigerian primary care and its significance largely unidentified. Hence, the need to determine the significance of detecting inter-arm blood pressure difference among primary care patients in our local population. This study was done to determine the point prevalence of inter-arm blood pressure difference and its relationship with hypertension and diabetes mellitus. Methods: A cross-sectional study was conducted among 214 respondents at the general outpatient clinic of a tertiary hospital in Nigeria. Demographic characteristics and anthropometric indices were obtained. Blood pressure readings were obtained through sequentially repeated measurements in respondents’ arms. Results: One hundred and eighty-six respondents had complete data given a completion rate of 86.9%. Systolic blood pressure was higher on the right and left arm in 102 (54.8%) and 56 (30.1%) of the respondents respectively. Diastolic blood pressure was higher on the right and left arm in 73 (39.2%) and 63 (33.9%) of the respondents respectively. The overall prevalence of significant systolic inter-arm difference (≥ 10 mmHg) and diastolic inter-arm difference (≥ 10 mmHg) were 24.2% and 18.8% respectively. Significant systolic inter-arm difference (p=0.033) and diastolic inter-arm difference (p=0.01) were significantly more among respondents with hypertension and/or diabetes mellitus. Conclusion: The blood pressure readings in both arms were different among majority of the respondents, being higher on the right arm in more of them. The prevalence of significant inter-arm difference was high in the unselected primary care patients studied especially among patients with hypertension and/or diabetes mellitus. Blood pressure measurement in both arms should become a routine practice during initial patients’ visits in primary care.

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