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Mean Blood Pressure of the General Population with the Mean of Three Measurements Versus the Mean of the Second and Third Measurements. Ricarto Study

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Abstract

Introduction

Our aim was to determine the difference between measuring blood pressure (BP) with the mean of three determinations versus the mean of the second and the third determinations in a random general population sample.

Methods

Epidemiological study of the general population aged ≥ 18 from the Health Area of Toledo (Spain), based on the health card database. Three readings of systolic and diastolic BP were taken with validated oscillometric devices OMRON HEM-907. The mean of the three readings was compared with the mean of the second and third readings after discarding the first measurement. We analyzed age, sex, BMI, abdominal obesity, dyslipidemia, diabetes mellitus, smoking and sedentary lifestyle. A descriptive study was conducted, as well as the agreement in the diagnosis of hypertension.

Results

1532 subjects were analyzed (mean age 49.01 ± 15.79 years old, 55.5% women). Response rate 36.3%. The mean systolic BP with three readings was 125.39 ± 17.43 mmHg, versus 124.33 ± 17.07 mmHg with the mean of the second and third readings (mean difference 1.01 ± 4.31; Cohen’s D = 0.059). The mean diastolic BP was 73.93 ± 10.89 versus 73.71 ± 10.93 mmHg with both methods (mean difference 0.19 ± 2.11; Cohen’s D = 0.017). Differences by age, sex, BMI, abdominal obesity, dyslipidemia, diabetes, smoking and sedentary lifestyle were all small (Cohen’s D < 0.08). The agreement between both models for classifying subjects as hypertensive/non-hypertensive showed a Kappa value = 0.936 (McNemar’s test p < 0.001).

Conclusions

Determining the mean of three readings of BP does not make a significant difference in relation to the reading of the second and third measurements in a sample of general population.

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Authors and Affiliations

  1. Toledo Multiprofessional Family and Community Care Teaching Unit, C/Barcelona 2, C.P. 45005, Toledo, Spain

    Alejandro Villarín Castro

  2. Preventive Medicine and Public Health, Research Unit, Castilla-La Mancha Institute of Health Sciences, Talavera de la Reina (Toledo), Avda. Madrid, s/n, Talavera de la Reina, C.P. 45600, Toledo, Spain

    Antonio Segura Fragoso

  3. Sillería Health Center (Toledo), C/Sillería, 2, C.P. 45001, Toledo, Spain

    Francisco Javier Alonso Moreno

  4. RICARTO Study, Toledo Primary Care Management, C/Barcelona, 2, C.P. 45005, Toledo, Spain

    Marta Sánchez Pérez

  5. Cardiology Department, Toledo University Hospital Complex, Avda. Barber, 30, C.P. 45071, Toledo, Spain

    Luis Rodríguez Padial

  6. La Puebla de Montalbán Health Center (Toledo), Avda. Álvaro de Montalbán, 19, La Puebla de Montalbán, C.P. 45516, Toledo, Spain

    Gustavo Cristóbal Rodríguez Roca

Authors
  1. Alejandro Villarín Castro
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  2. Antonio Segura Fragoso
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  3. Francisco Javier Alonso Moreno
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  4. Marta Sánchez Pérez
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  5. Luis Rodríguez Padial
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  6. Gustavo Cristóbal Rodríguez Roca
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Corresponding author

Correspondence to Alejandro Villarín Castro.

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Funding

This study was funded from 2011 to 2013 by the Government of Castilla-La Mancha, through a Grant for Biomedical and Health Sciences Research (file number PI-2010/043) from Castilla-La Mancha Social and Health Care Foundation (FISCAM). The Foundation of the Spanish Society of Primary Care Physicians (SEMERGEN) has been collaborating since 2013 in the funding of the RICARTO study with an unconditional grant.

Conflict of interest

The authors declare that there is no conflict of interest.

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Villarín Castro, A., Segura Fragoso, A., Alonso Moreno, F.J. et al. Mean Blood Pressure of the General Population with the Mean of Three Measurements Versus the Mean of the Second and Third Measurements. Ricarto Study. High Blood Press Cardiovasc Prev 26, 391–397 (2019). https://doi.org/10.1007/s40292-019-00338-0

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