The Present and Future
JACC Scientific Expert Panel
Blood Pressure Assessment in Adults in Clinical Practice and Clinic-Based Research: JACC Scientific Expert Panel

https://doi.org/10.1016/j.jacc.2018.10.069Get rights and content
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Abstract

The accurate measurement of blood pressure (BP) is essential for the diagnosis and management of hypertension. Restricted use of mercury devices, increased use of oscillometric devices, discrepancies between clinic and out-of-clinic BP, and concerns about measurement error with manual BP measurement techniques have resulted in uncertainty for clinicians and researchers. The National Heart, Lung, and Blood Institute of the U.S. National Institutes of Health convened a working group of clinicians and researchers in October 2017 to review data on BP assessment among adults in clinical practice and clinic-based research. In this report, the authors review the topics discussed during a 2-day meeting including the current state of knowledge on BP assessment in clinical practice and clinic-based research, knowledge gaps pertaining to current BP assessment methods, research and clinical needs to improve BP assessment, and the strengths and limitations of using BP obtained in clinical practice for research and quality improvement activities.

Key Words

blood pressure
hypertension
measurement

Abbreviations and Acronyms

ABPM
ambulatory blood pressure monitoring
ACC
American College of Cardiology
AF
atrial fibrillation
AHA
American Heart Association
AOBP
automated office blood pressure
BP
blood pressure
CVD
cardiovascular disease
DBP
diastolic blood pressure
EMR
electronic medical record
FDA
Food and Drug Administration
HBPM
home blood pressure monitoring
SBP
systolic blood pressure

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This work was supported by the Division of Cardiovascular Sciences (DCVS) of the National Heart, Lung, and Blood Institute (NHLBI). Dr. Muntner has received grant support from the American Heart Association (15SFRN2390002) and from Amgen Inc. Dr. Whelton has received grant support from the National Institute of General Medical Sciences of the National Institutes of Health (NIH) (P20GM109036). Dr. Bello has received grant support from the National Center for Advancing Translation Sciences (5KL2TR001874-02) and the National Heart, Lung, and Blood Institute (NHLBI) (K23HL136853-01A1). Dr. Green has received grant support from the Patient-Centered Outcomes Research Institute (CER-1511-32979 and IHS-1507-31146), and NHLBI (1R01HL136575). Dr. Jones has received grant support from the National Institute of General Medical Sciences (1U54GM115428). Dr. Juraschek has received grant support from NHLBI (7K23HL135273-02). Dr. Margolis has received grant support from the Patient-Centered Outcomes Research Institute (IHS-1507-31146) and NHLBI (R01HL090965). Dr. Navar has received grant support from NHLBI (K01 HL133416). Dr. Schwartz has received grant support from NHLBI (P01 HL47540). Dr. Shimbo has received grant support from NHLBI (K24-HL125704, R01HL117323, and P01 HL47540). Dr. Cushman has received institutional grant support from Eli Lilly; and has been a consultant to Sanofi and an uncompensated consultant to Novartis and Takeda. Dr. Navar has received institutional research support from Amgen, Amarin, Janssen, Regeneron, and Sanofi; and has been a consultant/served on advisory boards for Amarin, NovoNordisk, Amgen, and Sanofi. Dr. Rakotz is an employee of the American Medical Association. Dr. Stergiou has received institutional research support from iHealth, InBody, Maisense, and Microlife; and consulting fees from Maisense, Microlife, and Omron. The views expressed in this report are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the Department of Health and Human Services. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the American Medical Association. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.

© 2019 the American College of Cardiology Foundation. Published by Elsevier.