THE IMPACT OF PROPER METHODOLOGY ON THE ACCURACY OF OFFICE BLOOD PRESSURE MEASUREMENT: INSIGHTS FROM 2018 ESC/ESH GUIDELINES IN PROJECT CHARTER 2023

Objective: The accurate measurement of blood pressure (BP) is a cornerstone of hypertension (H) management. ESH/ESC Guidelines have established comprehensive guidelines to ensure the standardization and accuracy of BP measurement. CHARTER 70/2023 is an initiative of professional societies managing hypertension and patient organizations for better control of patients with hypertension in Slovakia This analysis focused on the proper methodology of office blood pressure (BP) measurement. Design and method: This project was conducted from April to June 2023 at 103 general physicians’ offices (GPO) in Slovakia. Results: We enrolled 3191 patients with H (52,5% women, mean age n 61,5 ± 8,2 years). On the visit 1 in GPO, 3 BP measurements were taken. The results of the first measurement (M1) were 142,9 (± 16,4) / 84,98 (±9,9) mm Hg, HR 73,96 (±9,8) bpm. Average of the 2nd and the 3rd measurement (M23) was 139,5 (±14,8) / 83,14 (±8,9) mm Hg, HR 72,99 (±9,1) bpm. Difference between M1 and M23 in was -3,4/-1,8 mm Hg, and -1,0 bpm, (p<0,0001). If there was only M1, 48% of patients would have BP <140/90 mm Hg, while evaluating average M23, the percentage of patients with BP lower than 140/90 mm Hg would be higher (55,5%) by 7,5%. Follow up on the visit 2 (V2): average BP on M1 136,16 (±12,8) /81,53 (±8,2) mm Hg, HR 72,70 (±8,9) bpm. Mean difference between M1 and M23 was -2,18/-1,34 mm Hg (p<0,0001), and -0,14 bpm (p<0,006). Percentage of patients with BP <140/90 mm Hg was higher. However, if there was only M1, 69,1% of patients would have BP <140/90 mm Hg, while assessing the average of M23, percentage of patients with BP lower than 140/90 mm Hg would be higher (74,3%). 5,2% of patients might have been classified and managed their disease differently. Conclusions: Proper methodology of BP measurement can result in more accurate diagnosis of hypertension. More patients (7,5% in Visit 1 and 5,2% in Visit 2) would be assessed as uncontrolled (BP > 140/90 mm Hg) if there was only one measurement vs three measurements.