Repeated BP measures linked to drop in initially elevated BP
Douglas Einstadter, M.D., M.P.H., from Case Western Reserve University in Cleveland, and colleagues examined the effect of a second BP measurement on the rate of BP control among patients with diagnosed HTN. An advisory alert was introduced into the electronic health record to remind staff to remeasure BP when the initial reading was elevated (≥140/90 mm Hg). A total of 38,260 patients with HTN made 80,864 primary care office visits during the study period.
The researchers found that the initial BP was at least 140/90 mm Hg at 39 percent of the visits, and an initially elevated BP was remeasured in 83 percent of cases. The median change in systolic BP was −8 mm Hg. There was a positive correlation for change in systolic BP with initial BP value, with a greater change in the final BP the higher the initial systolic BP. Also, among all the patients with a repeated measurement, 36 percent of final readings were below 140/90 mm Hg.
"Implementing routine repeated measurement for an initially elevated BP may contribute to improved decision making around HTN management and should be considered a standard component of programs to improve BP control," the authors write.
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