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134996 - Optimizing observer performance of clinic blood pressure.pdf (470.75 kB)

Optimizing observer performance of clinic blood pressure measurement: a position statement from the Lancet Commission on Hypertension Group

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journal contribution
posted on 2023-05-20, 07:12 authored by Padwal, R, Campbell, NRC, Schutte, AE, Olsen, MH, Delles, C, Etyang, A, Cruickshank, JK, Stergiou, G, Rakotz, MK, Wozniak, G, Jaffe, MG, Benjamin, I, Parati, G, James SharmanJames Sharman
High blood pressure (BP) is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. Accurate BP measurement is critical, given that a 5-mmHg measurement error may lead to incorrect hypertension status classification in 84 million individuals worldwide. This position statement summarizes procedures for optimizing observer performance in clinic BP measurement, with special attention given to low-to-middle-income settings, where resource limitations, heavy workloads, time constraints, and lack of electrical power make measurement more challenging. Many measurement errors can be minimized by appropriate patient preparation and standardized techniques. Validated semi-automated/automated upper arm cuff devices should be used instead of auscultation to simplify measurement and prevent observer error. Task sharing, creating a dedicated measurement workstation, and using semi-automated or solar-charged devices may help. Ensuring observer training, and periodic re-training, is critical. Low-cost, easily accessible certification programs should be considered to facilitate best BP measurement practice.


Publication title

Journal of Hypertension










Menzies Institute for Medical Research


Lippincott Williams & Wilkins

Place of publication

530 Walnut St, Philadelphia, USA, Pa, 19106-3621

Rights statement

Copyright 2019 The Authors. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified