Impact of Single-Occasion American vs. Canadian Office Blood Pressure Measurement Recommendations on Blood Pressure Classification.

Background: The 2017 American hypertension guidelines [American College of Cardiology/American Heart Association (ACC/AHA)] define a blood pressure measurement (BPM) procedure that differs from the Canadian Hypertension Education Program (CHEP) guidelines. We studied the impact of the BPM procedure on arterial hypertension (AHT) prevalence rate.

Methods: In 805 subjects, the mean of the first and second BPM (adapted ACC/AHA procedure) was compared with the mean of the second and third BPM (CHEP procedure). All BPMs were taken at a single occasion. According to ACC/AHA definition, office blood pressure (OBP) of <120/80 mm Hg was classified as normal, 120-129/<80 mm Hg as elevated, and ≥130/80 mm Hg as hypertensive.

Results: Using the adapted ACC/AHA BPM procedure compared to the CHEP BPM procedure led to an increase in the AHT prevalence rate (≥130/80 mm Hg) of 4% (58% vs. 54%). Overall, 8.9% (72/805) of subjects were reclassified to a higher and 2.6% (21/805) to a lower blood pressure category when using the adapted ACC/AHA BPM procedure instead of the CHEP BPM procedure. In the group with elevated OBP (120-129/<80 mm Hg), 41.9% (36/86) of subjects were reclassified.

Conclusions: Minimal changes of BPM procedures lead to relevant changes of hypertension prevalence.

Clinical Trials Registration: Trial Number NCT02552030.