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Misclassification of blood pressure of Vietnamese adults when only a single measurement is used

journal contribution
posted on 2023-05-19, 20:53 authored by Nga TranNga Tran, Christopher BlizzardChristopher Blizzard, Luong, KN, Truong, NLV, Tran, BQ, Veloudi, P, Petr OtahalPetr Otahal, Mark NelsonMark Nelson, Costan MagnussenCostan Magnussen, Seana GallSeana Gall, Tan BuiTan Bui, Srikanth, V, Au, TB, Ha, ST, Phung, HN, Tran, MH, Michele CallisayaMichele Callisaya, James SharmanJames Sharman
A single clinic measurement of blood pressure (BP) may be common in low- and middle-income countries because of limited medical resources. This study aimed to examine the potential misclassification error when only one BP measurement is used. Participants (n = 14,706, 53.5% females) aged 25-64 years were selected by multistage stratified cluster sampling from eight provinces, each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Data were analyzed using complex survey methods. For systolic BP, 62.7% had a higher first reading whereas 30.0% had a lower first reading, and 27.3% had a reduction of at least 5 mmHg whereas 9.6% had an increase of at least 5 mmHg. Irrespective of direction of change, increased variability in BP was associated with greater age, urban living, greater body size and fatness, reduced physical activity levels, elevated glucose, and raised total cholesterol. These measurement variations would lead to substantial misclassification in diagnosis of hypertension based on a single reading because almost 20% of subjects would receive a different diagnosis based on the mean of two readings.


Publication title

Journal of the American Society of Hypertension










Menzies Institute for Medical Research


Elsevier Inc.

Place of publication

United States

Rights statement

Copyright 2018 Published by Elsevier Inc. on behalf of American Heart Association.

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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