Two numbers to assess hypertension control, simple? Maybe not

摘要

I wish to congratulate the authors for an important, well-designed study outlining the 12/6 mm Hg higher blood pressure readings taken by the clinical staff using electronic monitors compared with the research staff in an academic family medicine practice.1 These clinically significant results are similar to a retrospective, electronic chart review that I performed showing an overestimation of 9/7 mm Hg by our medical assistants mostly using manual measurements and a similar 27% overread >140 mm Hg systolic blood pressure readings.2 This difference is equivalent to the effectiveness of a single antihypertensive drug. Most blood pressure measurements are performed outside research settings, yet a reviewer to my previous submission naively stated: "What is more, in these types of settings, blood pressure measurements are generally made by nurses and medical support staff trained in this field, not by medical assistants."