A minimal resting time of 25 min is needed before measuring stabilized blood pressure in subjects addressed for vascular investigations
Blood pressure (BP) measurement is a central element in clinical practice. According to international recommendations 3 to 5 minutes of resting is needed before blood pressure measurement. Surprisingly, no study has modelled the time course of BP decrease and the minimum resting-time before BP measu...
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Published in | Scientific reports Vol. 7; no. 1; pp. 12893 - 8 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Nature Publishing Group UK
10.10.2017
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Abstract | Blood pressure (BP) measurement is a central element in clinical practice. According to international recommendations 3 to 5 minutes of resting is needed before blood pressure measurement. Surprisingly, no study has modelled the time course of BP decrease and the minimum resting-time before BP measurement. A cross-sectional bicentric observational study was performed including outpatients addressed for vascular examination. Using two automatic BP monitors we recorded the blood pressure every minute during 11 consecutive minutes. The data was analyzed by non-linear mixed effect regression. Systolic (SBP) and diastolic BPs were studied and we tested the effect of covariates on its evolution through log-likelihood ratio tests. We included 199 patients (66+/−13years old). SBP was found to decrease exponentially. Simulations based on the final model show that only half the population reaches a stabilized SBP (defined as SBP + 5 mmHg) after 5 min of resting-time while it takes 25 min to ensure 90% of the population has a stabilized SBP. In conclusion, our results and simulations suggest that 5 minutes are not enough to achieve a stabilized SBP in most patients and at least 25 minutes are required. This questions whether the diagnosis of hypertension can be reliably made during routine visits in general practitioners’ offices. |
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AbstractList | Blood pressure (BP) measurement is a central element in clinical practice. According to international recommendations 3 to 5 minutes of resting is needed before blood pressure measurement. Surprisingly, no study has modelled the time course of BP decrease and the minimum resting-time before BP measurement. A cross-sectional bicentric observational study was performed including outpatients addressed for vascular examination. Using two automatic BP monitors we recorded the blood pressure every minute during 11 consecutive minutes. The data was analyzed by non-linear mixed effect regression. Systolic (SBP) and diastolic BPs were studied and we tested the effect of covariates on its evolution through log-likelihood ratio tests. We included 199 patients (66+/-13years old). SBP was found to decrease exponentially. Simulations based on the final model show that only half the population reaches a stabilized SBP (defined as SBP + 5 mmHg) after 5 min of resting-time while it takes 25 min to ensure 90% of the population has a stabilized SBP. In conclusion, our results and simulations suggest that 5 minutes are not enough to achieve a stabilized SBP in most patients and at least 25 minutes are required. This questions whether the diagnosis of hypertension can be reliably made during routine visits in general practitioners' offices.Blood pressure (BP) measurement is a central element in clinical practice. According to international recommendations 3 to 5 minutes of resting is needed before blood pressure measurement. Surprisingly, no study has modelled the time course of BP decrease and the minimum resting-time before BP measurement. A cross-sectional bicentric observational study was performed including outpatients addressed for vascular examination. Using two automatic BP monitors we recorded the blood pressure every minute during 11 consecutive minutes. The data was analyzed by non-linear mixed effect regression. Systolic (SBP) and diastolic BPs were studied and we tested the effect of covariates on its evolution through log-likelihood ratio tests. We included 199 patients (66+/-13years old). SBP was found to decrease exponentially. Simulations based on the final model show that only half the population reaches a stabilized SBP (defined as SBP + 5 mmHg) after 5 min of resting-time while it takes 25 min to ensure 90% of the population has a stabilized SBP. In conclusion, our results and simulations suggest that 5 minutes are not enough to achieve a stabilized SBP in most patients and at least 25 minutes are required. This questions whether the diagnosis of hypertension can be reliably made during routine visits in general practitioners' offices. Blood pressure (BP) measurement is a central element in clinical practice. According to international recommendations 3 to 5 minutes of resting is needed before blood pressure measurement. Surprisingly, no study has modelled the time course of BP decrease and the minimum resting-time before BP measurement. A cross-sectional bicentric observational study was performed including outpatients addressed for vascular examination. Using two automatic BP monitors we recorded the blood pressure every minute during 11 consecutive minutes. The data was analyzed by non-linear mixed effect regression. Systolic (SBP) and diastolic BPs were studied and we tested the effect of covariates on its evolution through log-likelihood ratio tests. We included 199 patients (66+/-13years old). SBP was found to decrease exponentially. Simulations based on the final model show that only half the population reaches a stabilized SBP (defined as SBP + 5 mmHg) after 5 min of resting-time while it takes 25 min to ensure 90% of the population has a stabilized SBP. In conclusion, our results and simulations suggest that 5 minutes are not enough to achieve a stabilized SBP in most patients and at least 25 minutes are required. This questions whether the diagnosis of hypertension can be reliably made during routine visits in general practitioners' offices. Blood pressure (BP) measurement is a central element in clinical practice. According to international recommendations 3 to 5 minutes of resting is needed before blood pressure measurement. Surprisingly, no study has modelled the time course of BP decrease and the minimum resting-time before BP measurement. A cross-sectional bicentric observational study was performed including outpatients addressed for vascular examination. Using two automatic BP monitors we recorded the blood pressure every minute during 11 consecutive minutes. The data was analyzed by non-linear mixed effect regression. Systolic (SBP) and diastolic BPs were studied and we tested the effect of covariates on its evolution through log-likelihood ratio tests. We included 199 patients (66+/−13years old). SBP was found to decrease exponentially. Simulations based on the final model show that only half the population reaches a stabilized SBP (defined as SBP + 5 mmHg) after 5 min of resting-time while it takes 25 min to ensure 90% of the population has a stabilized SBP. In conclusion, our results and simulations suggest that 5 minutes are not enough to achieve a stabilized SBP in most patients and at least 25 minutes are required. This questions whether the diagnosis of hypertension can be reliably made during routine visits in general practitioners’ offices. |
ArticleNumber | 12893 |
Author | Mahe, Guillaume Le Faucheur, Alexis Comets, Emmanuelle Dourmap, Caroline Nouni, Aziz Jaquinandi, Vincent Paillard, François |
Author_xml | – sequence: 1 givenname: Guillaume surname: Mahe fullname: Mahe, Guillaume email: maheguillaume@yahoo.fr organization: Unité de médecine vasculaire, centre de cardio-prévention, ESH Hypertension Excellence Centre, CHU Rennes, INSERM, Centre d’investigation clinique, CIC 1414, Université de Rennes 1 (Univ Rennes1) – sequence: 2 givenname: Emmanuelle surname: Comets fullname: Comets, Emmanuelle organization: INSERM, Centre d’investigation clinique, CIC 1414, Université de Rennes 1 (Univ Rennes1), INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité – sequence: 3 givenname: Aziz surname: Nouni fullname: Nouni, Aziz organization: Unité de médecine vasculaire, centre de cardio-prévention, ESH Hypertension Excellence Centre, CHU Rennes, Centre hospitalier du Centre Bretagne – sequence: 4 givenname: François surname: Paillard fullname: Paillard, François organization: Unité de médecine vasculaire, centre de cardio-prévention, ESH Hypertension Excellence Centre, CHU Rennes – sequence: 5 givenname: Caroline surname: Dourmap fullname: Dourmap, Caroline organization: Unité de médecine vasculaire, centre de cardio-prévention, ESH Hypertension Excellence Centre, CHU Rennes – sequence: 6 givenname: Alexis surname: Le Faucheur fullname: Le Faucheur, Alexis organization: Movement, Sport and Health laboratory. EA 1274. UFR APS. Université de Rennes 2 (Rennes 2 university), Department of Sport sciences and physical education, Ecole normale supérieure de Rennes, Campus de Ker Lann – sequence: 7 givenname: Vincent surname: Jaquinandi fullname: Jaquinandi, Vincent organization: Unité de médecine vasculaire, centre de cardio-prévention, ESH Hypertension Excellence Centre, CHU Rennes, INSERM, Centre d’investigation clinique, CIC 1414 |
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SubjectTerms | 692/699/75 692/699/75/243 Blood pressure Cardiology and cardiovascular system Data processing Human health and pathology Humanities and Social Sciences Hypertension Life Sciences multidisciplinary Observational studies Pressure measurement Science Science (multidisciplinary) Tissues and Organs |
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Title | A minimal resting time of 25 min is needed before measuring stabilized blood pressure in subjects addressed for vascular investigations |
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