The Implications of Blood Pressure Measurement Methods on Treatment Targets for Blood Pressure

Over the past 45 years, a number of clinical outcome trials have evaluated the effects of blood pressure (BP) reduction on cardiovascular outcomes.1 Most recently, SPRINT (Systolic Blood Pressure Intervention Trial) randomly assigned 9361 persons with a systolic blood pressure (SBP) of ≥130 mm Hg and increased cardiovascular risk to a SBP target u003c120 mm Hg versus u003c140 mm Hg. Although the results of SPRINT provide evidence that the goal SBP should be closer to 120 than 140 mm Hg, the methods of BP measurement were notably different between this trial and many others. More important, the methodology for measuring BP in SPRINT is not what is used in most clinical practices, and this difference has significant clinical implications.Most cardiovascular outcome trials, to date, have used either ausculatory or automatic oscillometric methods of seated BP measurement performed shortly after the patient’s arrival for a visit, with similar methods currently used in most clinical practices. The SPRINT methodology is not in widespread use clinically; BP was measured after the participant sat quietly alone for 5 minutes, after which study personnel returned to the room to measure BP 3 times at 1-minute intervals with all 3 values averaged.BP recorded in research studies using the standard BP …