A Comparison of Casual In-Clinic Blood Pressure Measurements to Standardized Guideline-Concordant Measurements in Severely Obese Individuals

Abstract EN

Background/Objectives.

The objective of this study was to compare casual BP taken in a bariatric clinic to standardized guideline-concordant BP.

Subjects/Methods.

A cross sectional analysis was performed using baseline data from a weight management trial.

Patients were recruited from a Canadian bariatric care program.

Standardized BP was performed using a Watch BP oscillometric device.

Casual in-clinic BP single readings, taken using a Welch Allyn oscillometric device, were chart-abstracted.

Paired t -tests, Bland-Altman plots, and Pearson’s correlations were used for analysis.

Results.

Data from 134 patients were analyzed.

Mean age was 41.5 ± 8.9 y, mean BMI was 46.8 ± 6.5 kg/m2, and 40 (30%) had prior hypertension.

Mean casual in-clinic BP was 128.8 ± 14.1/81.6 ± 9.9 mmHg and mean standardized BP was 133.2 ± 15.0/82.0 ± 10.3 mmHg (difference of −4.3 ± 12.0 for systolic ( p < 0.0001 ) and −0.4 ± 10.0 mmHg for diastolic BP ( p = 0.6 )).

Pearson’s coefficients were 0.66 ( p < 0.0001 ) for SBP and 0.50 ( p < 0.0001 ) for DBP.

28.4% of casual versus 26.9% of standardized measurements were ≥140/90 mmHg ( p < 0.0001 ).

Conclusion.

In this bariatric clinic, casual BP was unexpectedly lower than standardized BP.

This could potentially lead to the underdiagnosis of hypertension.