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Blood Pressure Measurement Biases in Clinical Settings, Alabama, 2010–2011

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Figure 1. Percentage of participants with uncontrolled high blood pressure (mm Hg) as determined by clinical blood pressure (clinical BP) and research blood pressure (research BP), overall and by age group among community-dwelling adults with diabetes (n = 227), Alabama, 2010–2011. For clinical BP measurement, nurses or medical assistants were instructed to “take the participant’s blood pressure like you do in your own clinic.” The research BP was measured following a protocol similar to Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) recommendations (2). Abbreviation: SBP, systolic BP.

Blood Pressure Clinical BP, % Research BP, %
SBP ≥130 mm Hg
Overall 81.9 73.6
Age <65 82.2 74.5
Age ≥65 81.4 71.4
SBP ≥140 mm Hg
Overall 58.6 49.3
Age <65 56.0 49.0
Age ≥65 64.3 50.0

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Figure 2. Differences between clinical blood pressure (clinical BP) and research blood pressure (research BP) among community-dwelling adults with diabetes (n = 227; data were missing for 3 participants), Alabama, 2010–2011. For clinical BP measurement, nurses or medical assistants were instructed to “take the participant’s blood pressure like you do in your own clinic.” The research BP was measured following a protocol similar to Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) recommendations (2).

Difference Between Clinical BP and Research BP, mm Hg Percentage
<−5 23.3
≥−5 to <−2 6.2
≥−2 to <0 5.3
≥0 to <2 4.4
≥2 to <5 11.0
≥5 49.8

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