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Skipping pre-reading rest could make for more efficient BP screening

AHA Hypertension 2020
Reuters Health - 10/09/2020 - Shortening or even eliminating the five-minute rest time before initiating a blood pressure (BP) reading could make BP screening more efficient, particularly in low-resource settings, new findings suggest.

For adults with systolic BP readings below 140 mmHg, measurements taken after a two-minute rest or with no rest period were non-inferior to readings taken after a five-minute rest, Dr. Tammy McLoughlin Brady and colleagues from Johns Hopkins University School of Medicine in Baltimore, Maryland, found.

The results were presented at the American Heart Association's virtual Hypertension 2020 Scientific Sessions.

American Heart Association guidelines recommend that patients rest for at least five minutes before BP measurement is initiated. "There's been some studies to show that this is not really adhered to perfectly," Dr. Brady told Reuters Health by phone. "A lot of people aren't necessarily doing that in clinical practice."

She noted that the five-minute recommendation is based on just two studies, both done in patients with hypertension.

In the new study, Dr. Brady and her colleagues performed four sets of BP measurements in 113 community-dwelling adults. The first three measurements were done after no rest, two minutes' rest or five minutes' rest, in random order, while the fourth repeated the five-minute rest. The investigators defined non-inferiority as a difference of 2 mm Hg or less between readings.

Mean BP measurements after the two sets of measurements with five minutes of rest were 128/75 and 127/76. Overall, this was similar to the measurements with no rest and two minutes of rest, which were each 127/74.

Accuracy with the shorter rest periods was non-inferior to the five-minute rest period for individuals with systolic blood pressure below 140, but not for the 32 patients with systolic BPs above 140.

"The study suggests that a potential screening strategy would be to measure blood pressure without any wait in all patients," Dr. Brady said. Patients who were found to have elevated blood pressure would then undergo a repeated measurement after a five-minute rest period, she explained.

"This strategy could potentially really enhance screening efforts, which would then enhance our efforts at reducing cardiovascular disease burden globally," she said.

By Anne Harding

SOURCE: https://bit.ly/3k6uTjW AHA Hypertension 2020 Scientific Sessions, September 10, 2020.

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