Challenges in standardization of blood pressure measurement at the population level
The CRONICAT program is developing a Project for the Control of Hypertension in three areas of central Catalonia. In the analysis of the blood pressure data of the registry of patients from this project, carried out 18 months after its beginning, it was found that a high proportion of blood pressure (BP) readings showed 0 or 5 as the terminal digit (57.3% and 16.6% in diastolic BP, and 66.6% and 11.8% in systolic BP, respectively). To improve the quality of the reading two continuing education activities were carried out; a seminar where a practical session of blood pressure measurement was developed, using a videotape with 12 BP recordings permitting to see the interobserver and intraobserver variability, and discussion meetings with all the primary care teams which participate in the Project. 36 months after the beginning a new analysis of data was carried out, and it was found that the preference for 0 and 5 had decreased to 41.1% and 7.5% for diastolic BP and to 51.3% and 8.2% for had decreased to 41.1% and 7.5% for diastolic BP and to 51.3% and 8.2% for systolic BP, respectively. A higher preference for terminal digits was maintained in systolic BP, although the results obtained in the practical session with the videotape showed a greater dispersion of results in diastolic BP.