Abstract
Blood pressure (BP) screening is important to identify those at risk of cardiovascular disease, but there has been little data on the appropriate interval of screening. We aimed to evaluate the optimal interval and the best measure for BP re-screening by estimating the long-term, true change variance (‘signal’) and short-term, within-person variance (‘noise’). Study design was a cohort study from 2005 to 2008. Target population was Japanese healthy adults not taking antihypertensive medication at baseline, in a teaching hospital. We measured annually the systolic BP (SBP) and the diastolic BP (DBP), and calculated the pulse pressure (PP) and the mean arterial pressure (MAP). A total of 15 055 individuals (51% male) with a mean age of 49 years had annual check-ups. Short-term coefficient of variation was lowest for MAP at 5.2%, followed by SBP (5.7%) and DBP (5.8%), and highest for PP (12%). After 3 years, the ‘signal’ of true BP changes of only SBP and MAP equaled the ‘noise’ of BP measurement; however, it was larger for those with higher initial BPs. SBP or MAP appears to be a better screening measure. The optimal interval should be 3 years or more, with SBP<130 mm Hg and 2 years for those with SBP⩾130 mm Hg.
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Acknowledgements
We would like to thank Tomoya Okubo, Haruhiko Ohde and Asuka Nemoto for their statistical support; Sachiko Ohde, Mina Shapiro and Gautam Deshpande for their helpful comments; Jiro Suwa and Sonoe Hiramatsu for the data collection. This work was supported in part by a UK National Institute for Health Research (NIHR) National School of Primary Care, Department of Health grant, by a UK NIHR Health Technology Assessment (HTA) program grant, and from a grant by the Ministry of Health, Labor and Welfare in Japan for the study of the evidence-based guideline development of screening (H19-Med-General-016) and St Luke’s Life Science Institute.
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Takahashi, O., Glasziou, P., Perera, R. et al. Blood pressure re-screening for healthy adults: what is the best measure and interval?. J Hum Hypertens 26, 540–546 (2012). https://doi.org/10.1038/jhh.2011.72
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DOI: https://doi.org/10.1038/jhh.2011.72