Abstract
Objectives - Precise, reliable blood pressure (BP) measurement, whether in clinical practice or in epidemiological research, is essential for diagnosis and data interpretation. The study objectives were to compare differences in the prevalence and control of hypertension among adults aged 18 years and older using two standard devices: the mercury sphygmomanometer and the Omron Digital Blood Pressure Monitor (HEM_907XL). Methods - 5,185 individuals aged 18 years and older participated in the National Health and Nutrition Examination Survey 2009-2010 BP methodology study. Hypertension was defined as a mean systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg, or currently taking BP medication. Mean BP was the average of up to three readings for each device. Controlled Hypertension among hypertensives was defined as SBP <140 mmHg and DBP < 90 mmHg. Results - Overall the age-adjusted prevalence of hypertension among adults was higher by mercury measurement (27.7%) than by Omron (26.4%, p <0.05). There were significant differences in hypertension prevalence between the two devices among men (mercury: 28.9% vs. Omron: 26.5%, p < 0.05) and Hispanics (mercury: 25.1% vs. Omron: 22.8%, p < 0.05). The overall hypertension control rate among hypertensives was significantly higher using Omron (64.6%) vs. mercury measurement (57.5%, p <0.05). In subgroup analyses, rates of hypertension control among hypertensives were systematically higher using Omron: for those 40-59 years (mercury: 60.0%; Omron: 67.9%); for those 60 years and older (mercury: 59.7%; Omron: 65.4%); for men (mercury: 54.9%; Omron: 63.9%); women (mercury: 61.5%; Omron: 66.1%,); non-Hispanic whites (mercury: 60.9%; Omron: 68.4%); non-Hispanic blacks(mercury: 48.8%; Omron: 54.3%); and Hispanics (mercury: 34.6%; Omron: 44.8%), ( p <0.05 for all groups). Conclusion - Hypertension prevalence measured by mercury was significantly higher than that measured by the Omron device. Lower Omron readings resulted in apparently higher estimates for the rate of controlled hypertension.
Published Version
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