A1 Refereed original research article in a scientific journal
Misclassification of blood pressure of Vietnamese adults when only a single measurement is used
Authors: Tran NTT, Blizzard CL, Luong KN, Truong NLV, Tran BQ, Veloudi P, Otahal P, Nelson M, Magnussen C, Gall S, Bui TV, Srikanth V, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Sharman J
Publisher: ELSEVIER SCIENCE INC
Publication year: 2018
Journal: Journal of the American Society of Hypertension
Journal name in source: JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION
Journal acronym: J AM SOC HYPERTENS
Volume: 12
Issue: 9
First page : 671
Last page: 680
Number of pages: 10
ISSN: 1933-1711
DOI: https://doi.org/10.1016/j.jash.2018.06.015
Abstract
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.
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.
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