High BP is the leading risk factor for cardiovascular and kidney disease worldwide, and lowering BP substantially reduces that risk and improves patient outcomes. Clinical practice guidelines and position statements have strongly recommended and provided detailed protocols for standardized office BP measurement for decades. Yet, standardized BP measurement is not implemented in most clinical practices. Recognizing that effective BP management relies primarily on accurate BP measurement, these 13 scientific health organizations collaborated on a joint statement with the goal of emphasizing the importance of, and introducing a pragmatic approach to, standardized clinic BP measurement in clinical practice.
“Many patients, clinical practices, and agencies do not appreciate the importance of standardization in blood pressure measurement,” said Alfred Cheung, MD, a co-author of the statement. “The necessary steps are often considered time-consuming and unnecessary, even though they are essential to managing hypertension. We hope to show in this statement that it is both possible and practical to streamline clinic workflows in a way that minimizes the amount of time required to perform standardized BP measurements.”
The joint statement is based on a consensus among guideline developers, implementation scientists and clinicians that standardized BP measurements are an essential part of clinical practice, but efforts to implement the guideline-recommended preparations have fallen short. This led the panel to carefully examine the procedures recommended in clinical practice guidelines and to compile the core elements that are supported by consensus among the authors. The statement is not intended to provide a comprehensive review of the literature or a summary of other detailed guidelines, nor is it intended to reconcile differences across guidelines. Instead, the statement aims to balance the rigor of BP measurement techniques used in all hypertension outcome trials with the practicality of daily clinical practice.
“We believe that a simplified, standardized BP measurement protocol will lead to wider adoption in daily practice, with minimal compromise in measurement accuracy and reliability,” said co-author, Johannes Mann, MD (DE). “The goal of this joint statement is to ensure that healthcare organizations, healthcare professionals, and patients can have greater confidence that the BP measurements used to guide management will improve clinical outcomes.
“KDIGO is grateful for the opportunity to collaborate with such prestigious organizations on this important statement,” said KDIGO CEO, John Davis. “We hope this statement facilitates changes in clinical practice that will directly impact improved care for all people, not only those with kidney disease, worldwide.”
The joint statement was authored by Alfred Cheung, MD (KDIGO, US); Paul Whelton, MD (World Hypertension League [WHL], US); Paul Muntner, PhD (KDIGO, American Heart Association [AHA], US); Aletta E. Schutte, PhD (International Society of Hypertension [ISH] & Lancet Commission of Hypertension, AU); Andrew E. Moran, MD (Resolve to Save Lives, US); Bryan Williams, MD (European Society of Cardiology [ESC], UK); Pantelis Sarafidis, MD (European Society of Hypertension [ESH], GR); Tara Chang, MD (KDIGO, US), Stella Daskalopoulou, MD (Hypertension Canada, CA); John M. Flack, MD (AHA, US); Garry Jennings, MD (National Heart Foundation of Australia, AU); Stephen P. Juraschek, MD (AHA, US); Reinhold Kreutz, MD (ESH, DE); Giuseppe Mancia, MD (ESH, IT); Shawna Nesbitt, MD (AHA, US); Pedro Ordunez, MD (Pan American Health Organization, US); Raj Padwal, MD (Hypertension Canada, CA); Alexandre Persu, MD (ESH, BE); Doreen Rabi, MD (Hypertension Canada, CA); Markus P. Schlaich, MD (High Blood Pressure Research Council of Australia, AU); George S. Stergiou, MD (ESH & ISH, GR); Sheldon W. Tobe, MD (Hypertension Canada & KDIGO, CA); Maciej Tomaszewski, MD (ISH, UK); Kim Williams, MD (American College of Cardiology, US); Johannes F.E. Mann, MD (KDIGO, DE).