How well do clinic-based blood pressure measurements agree with the mercury standard?

<bold>Background: </bold>Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP measurement.<bold>Objective: </bold>To examine agreement between real-time clinic-based assessment of BP and the standard mercury assessment of BP.<bold>Design: </bold>Prospective reliability study.<bold>Patients: </bold>One hundred patients with an International Classification of Diseases-9th edition code for hypertension were enrolled.<bold>Measures: </bold>Two BP measurements were obtained with the Hawksley random-zero mercury sphygmomanometer and averaged. The clinic-based BP was extracted from the computerized medical records.<bold>Results: </bold>Agreement between the mercury and clinic-based systolic blood pressure (SBP) was good, intraclass correlation coefficient (ICC)=0.91 (95% confidence interval (CI): 0.83 to 0.94); the agreement for the mercury and clinic-based diastolic blood pressure (DBP) was satisfactory, ICC=0.77 (95% CI: 0.62 to 0.86). Overall, clinic-based readings overestimated the mercury readings, with a mean overestimation of 8.3 mmHg for SBP and 7.1 mmHg for DBP. Based on the clinic-based measure, 21% of patients were misdiagnosed with uncontrolled hypertension.<bold>Conclusions: </bold>Health professionals should be aware of this potential difference when utilizing clinic-based BP values for making treatment decisions and/or assessing quality of care. [ABSTRACT FROM AUTHOR]