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Simplified hypertension screening methods across 60 countries: An observational study

Carrillo-Larco RM, Guzman-Vilca WC, Neupane D
PLoS Med

Why was this study done?

To measure blood pressure, one usually needs to take 3 measurements, waiting 3 minutes between measurements, and compute the average of the last 2 measurements.

Because this standard protocol takes time and reduces the number of people who can be screened for hypertension, simplified screening approaches have been proposed (e.g., only taking 2 measurements), yet these simplified approaches have not been studied worldwide.

What did the researchers do and find?

We considered 9 simplified approaches and computed the number of cases that would be missed—and the number of cases that would be over-diagnosed—in comparison to the standard protocol, and described the cardiovascular risk profile in these groups.

Two simplified approaches had the smallest misdiagnosis rates, though these rates differed between countries: using only the second blood pressure measurement (not the average of the last 3) and using the second blood pressure measurement if the first one was 130–145/80–95 mm Hg.

What do these findings mean?

Worldwide, simplified blood pressure screening approaches appear to be reliable for hypertension screening without missing many cases.

Countries should identify the best simplified screening approach according to the local blood pressure distribution, hypertension epidemiology, and available resources for massive blood pressure screening programmes targeting the general population.