Barriers to accurate blood pressure measurement in the medical office
Open accessAbstract
Background: Despite the high prevalence of blood pressure (BP) measurement errors in the outpatient setting, little is known about why primary care clinics struggle to achieve consistently accurate BP measurements in routine practice. We investigated barriers affecting measurement of BP for adult patients in primary care. Methods: We conducted a qualitative evaluation in 6 adult primary care clinics. BP measurement was observed during 54 routine patient encounters. Six managers completed semistructured interviews and 18 clinical staff members participated in focus group discussions. We used an inductive, data-driven approach to identify and organize findings into cohesive, overarching themes describing factors affecting BP measurement. Results: Observed errors in BP measurement spanned the entire spectrum of steps required to obtain BP properly. Barriers to proper BP measurement were related to staff knowledge and behavior (inadequate knowledge, training, and feedback); workflow constraints (need to multitask, inadequate time); and equipment issues (BP monitors, seating). Patient characteristics and behavior also affected BP measurement. Conclusions: Correct measurement of BP is affected by a wide range of factors and is challenging to accomplish consistently in primary care. These findings may inform the design of performance improvement programs to maximize the quality of BP measurement in the outpatient setting.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The evidence base for blood pressure targets using ambulatory or home monitoring is uncertain, so their role should be considered complementary to standardized clinic blood pressure measurement unless clinic measurements are unavailable.
“As such, the evidence base to support BP targets using ABPM or HBPM is uncertain and their role at present should be considered complementary to standardized clinic BP measurements, unless clinic BP measurements are unavailable.23”
From International Consensus on Standardized Clinic Blood Pressure Measurement – A Call to Action (2023) · cites this paper as [23]
The Introduction (page unavailable) says office BP measurement remains the de facto method in routine care and that major hypertension trials used office BP to guide treatment. It does not assess whether evidence for ABPM or HBPM targets is uncertain or recommend using those methods only as complements to standardized clinic measurements unless clinic measurements are unavailable. (LLM, conf=0.84)
Experimental — accuracy not yet measuredStandardization of blood pressure measurement is not implemented in most clinical practices, because its importance is underappreciated and the required steps are seen as time-consuming and impractical.
“Despite these efforts, standardization is not implemented in most clinical practices18 because its importance is often underappreciated, and the necessary steps are considered time-consuming and impractical.23”
From International Consensus on Standardized Clinic Blood Pressure Measurement – A Call to Action (2023) · cites this paper as [23]
The Results (Workflow; Staff Knowledge and Behavior, page unavailable) report that staff lacked time for recommended steps and found them difficult to apply in a busy clinic. The paper does not establish that the importance of standardized measurement was underappreciated. The separate claim about most clinical practices is attached to citation 18, not this source. (LLM, conf=0.84)
Experimental — accuracy not yet measuredStandardization is essential because many aspects of blood pressure measurement, including the patient's physical condition, the clinic environment and the equipment, can readily produce inaccurate and unreliable values.
“Standardization is essential because there are many aspects of BP measurement, including the patient’s physical condition, clinic environment, and equipment that can readily result in inaccurate and unreliable values.23,25,26”
From International Consensus on Standardized Clinic Blood Pressure Measurement – A Call to Action (2023) · cites this paper as [23]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391 · cited 2× · see citing works
“Accurate BP measurement involves patient preparation and positioning, technique, timing, and equipment.(7,9) Clinic staff must be instructed on correct technique, have the skills to apply their knowledge, and have enough time to measure BP correctly.”
BackgroundPickering, T. G., Hall, J. E., Appel, L. J., Falkner, B. E., Graves, J., Hill, M. N., Jones, D. W., Kurtz, T., Sheps, S. G., & Roccella, E. J. (2005) · Circulation · doi:10.1161/01.cir.0000154900.76284.f6 · Cited by 3,985 · see citing works
[A randomized trial of intensive versus standard blood pressure control].
Garrote, J. A. D., & Cervantes, C. (2016) · Semergen · doi:10.1016/j.semerg.2015.12.009 · Cited by 3,328 · cited 2× · see citing works
“Furthermore, major HTN trials have used office BP to define eligibility and guide medication titration.(5,6) Clinical guidelines emphasize the importance of accurate office BP measurement for diagnostic and treatment decisions.”
BackgroundMethodForouzanfar, M. H., Alexander, L., Anderson, H. R., Bachman, V. F., Biryukov, S., Brauer, M., Burnett, R., Casey, D., Coates, M. M., Cohen, A., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00128-2 · Cited by 2,701 · see citing works
A Randomized Trial of Intensive versus Standard Blood-Pressure Control.
Chugh, S. (2017) · New England Journal of Medicine · doi:10.1056/nejmx170008 · Cited by 2,413 · see citing works
Pickering, T. G., Hall, J. E., Appel, L. J., Falkner, B. E., Graves, J., Hill, M. N., Jones, D. W., Kurtz, T., Sheps, S. G., & Roccella, E. J. (2005) · Hypertension · doi:10.1161/01.hyp.0000150859.47929.8e · Cited by 2,051 · see citing works
Forouzanfar, M., Alexander, L. T., Anderson, Bachman, R., Biryukov, V. F., Brauer, S., Burnett, M., Casey, R., Coates, D., Cohen, M., et al. (2015) · BDJ · doi:10.1038/sj.bdj.2015.751 · Cited by 1,770 · see citing works
The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting
Hemming, K., Haines, T. P., Chilton, P. J., Girling, A. J., & Lilford, R. J. (2015) · BMJ · doi:10.1136/bmj.h391 · Cited by 1,410 · cited 1× · see citing works
“A stepped wedge cluster trial might be appropriate for cliniclevel BP measurement interventions when consent or randomization by patient or staff member is not feasible.(24) Possible evaluation approaches include video observation, use of standardized patients, and tracking outcomes through the electronic health recor…”
MethodWhelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000596 · Cited by 1,127 · see citing works
Siu, A., Bibbins-Domingo, K., Grossman, D. C., Baumann, L., Davidson, K. W., Ebell, M., García, F. A. R., Gillman, M. W., Herzstein, J., Kemper, A. R., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m15-2223 · Cited by 434 · see citing works
Measuring Blood Pressure for Decision Making and Quality Reporting: Where and How Many Measures?
Powers, B. J., Olsen, M. K., Smith, V. A., Woolson, R. F., Bosworth, H. B., & Oddone, E. Ž. (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-154-12-201106210-00005 · Cited by 184 · cited 1× · see citing works
“For example, in a study of 444 veterans with uncontrolled HTN, there were substantial differences between routine office BP and research quality BP measurements, the latter of which involved taking 2 readings 5 minutes apart.(12) The mean clinic systolic BP of 144.”
ResultKerr, E. A., Zikmund‐Fisher, B. J., Klamerus, M. L., Subramanian, U., Hogan, M. M., & Hofer, T. P. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-148-10-200805200-00004 · Cited by 176 · cited 1× · see citing works
“In a study in Veterans Affairs facilities, providers recorded a repeated BP value in only 45% of office visits.(15) Other studies have demonstrated that incorrect BP measurement yields falsely high readings.”
BackgroundMcguckin, M., Taylor, A., Martin, V., Porten, L., & Salcido, R. (2004) · American Journal of Infection Control · doi:10.1016/j.ajic.2003.10.005 · Cited by 153 · see citing works
Kronish, I. M., Kent, S., Moise, N., Shimbo, D., Safford, M. M., Kynerd, R. E., O'Beirne, R., Sullivan, A., & Muntner, P. (2017) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2017.06.012 · Cited by 145 · cited 1× · see citing works
“Although out-of-office monitoring is recommended for assessing blood pressure (BP) status,(3) many practices face challenges in adopting ambulatory BP monitoring and home BP self-monitoring.(4) In routine care, office BP measurement remains the de facto method to screen for, diagnose, and monitor treatment of HTN.”
BackgroundPrevalence of white-coat and masked hypertension in national and international registries
Gorostidi, M., Vinyoles, E., Banegas, J. R., & de la Sierra, A. (2015) · Hypertension Research · doi:10.1038/hr.2014.149 · Cited by 141 · cited 1× · see citing works
“An estimated 10% to 50% of patients with high office BP readings have normal BP outside the office.(17) Improper measurement technique leading to falsely elevated BP measurements can lead to unnecessary initiation or escalation of BP medications with their attendant adverse effects and added costs.”
BackgroundAssociation of Repeated Measurements With Blood Pressure Control in Primary Care
Einstadter, D., Bolen, S., Misak, J. E., Bar-Shain, D. S., & Cebul, R. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.0315 · Cited by 67 · cited 1× · see citing works
“If this is not feasible, then at the very minimum, an initially high BP reading should be repeated.(19) If clinic staff struggle to obtain multiple readings, the use of an automated office BP device (AOBP) should be considered,(7) as was done in the SPRINT trial.”
MethodBlood pressure rising: differences between current clinical and recommended measurement techniques.
Burgess, S., MacLaughlin, E., Smith, P. A., Salcido, A., & Benton, T. (2011) · Journal of the American Society of Hypertension : JASH · doi:10.1016/j.jash.2011.08.007 · Cited by 45 · see citing works
Elliott, W. (2012) · Yearbook of Cardiology · doi:10.1016/j.ycar.2012.02.030 · Cited by 40 · cited 3× · see citing works
“The average of multiple readings obtained by AOBP is comparable to mean awake ambulatory BP.(20,21) Clinics that use examination tables for BP measurement should be outfitted with chairs that support of the patient’s arms, back, and feet.”
MethodBP Measurement in Clinical Practice: Time to SPRINT to Guideline-Recommended Protocols.
Drawz, P., & H., J. (2017) · Journal of the American Society of Nephrology · doi:10.1681/asn.2017070753 · Cited by 38 · cited 1× · see citing works
“Furthermore, major HTN trials have used office BP to define eligibility and guide medication titration.(5,6) Clinical guidelines emphasize the importance of accurate office BP measurement for diagnostic and treatment decisions.”
BackgroundBlood Pressure Monitoring Technique Impacts Hypertension Treatment
Ray, G. M., Nawarskas, J., & Anderson, J. R. (2012) · Journal of general internal medicine · doi:10.1007/s11606-011-1937-9 · Cited by 38 · cited 2× · see citing works
“recommended BP measurement procedures usually produces falsely elevated BP readings,(10-12) leading to inappropriate treatment.(13) The quality of office BP measurement has been described,(12,14,15) but these studies did not explore the reasons why a health care organization may struggle to consistently obtain high-qu…”
BackgroundEvaluation of an automated sphygmomanometer for use in the office setting
Myers, M., & Valdivieso, M. (2012) · Blood Pressure Monitoring · doi:10.1097/mbp.0b013e3283540785 · Cited by 35 · cited 3× · see citing works
“The average of multiple readings obtained by AOBP is comparable to mean awake ambulatory BP.(20,21) Clinics that use examination tables for BP measurement should be outfitted with chairs that support of the patient’s arms, back, and feet.”
MethodThe ACC/AHA 2017 Hypertension Guidelines: Both Too Much and Not Enough of a Good Thing?
Cohen, J., & Townsend, R. (2017) · Annals of Internal Medicine · doi:10.7326/m17-3103 · Cited by 28 · cited 1×
“Application of guidelines without accurate BP measurement may create a gap between outcomes observed in clinical practice and those observed in clinical trials.(8) Accurate BP measurement involves patient preparation and positioning, technique, timing, and equipment.”
MethodImproving the Measurement of Blood Pressure: Is It Time for Regulated Standards?
Appel, L., Miller, E., & Charleston, J. (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-154-12-201106210-00014 · Cited by 25 · cited 1× · see citing works
“Experts have called for a regulatory agency to monitor adherence to BP measurement standards.(22) The ultimate beneficiaries of proper BP measurement (patients) may serve as the most compelling “regulatory” agents.”
MethodPitfalls in blood pressure measurement in daily practice
Houweling, S. T., Kleefstra, N., Lutgers, H. L., Groenier, K. H., Jong, B. M., & Bilo, H. J. G. (2005) · Family Practice · doi:10.1093/fampra/cmi096 · Cited by 22 · see citing works
Diagnosing Hypertension in Primary Care Clinics According to Current Guidelines
Woolsey, S., Brown, B. A., Ralls, B., Friedrichs, M. D., & Stults, B. M. (2017) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2017.02.160111 · Cited by 22 · cited 1× · see citing works
“In a survey of primary care practices in Utah, only 58% of clinics reported allowing patients to rest at least 5 minutes before measuring BP and only 59% reported using the mean of 2 measurements.(14) Those authors acknowledged that because these were self-reported questionnaires, the figures probably overestimated ad…”
Background
Flagged first, then by citations
1 of the 26 references couldn’t be matched to a known paper.
Research works printed but not linked: 3
- [2]Yoon SS Fryar CD Carroll MD. Hypertension Prevalence and Control Among Adults: United States, 2011-2014. Hyattsville, MD: National Center for Health Statistics; 2015. 26633197
- [16]Tong A Sainsbury P Craig J. Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007; 19: 349- 357. 17872937
- [18]Nolan TW. Execution of Strategic Improvement Initiatives to Produce System-Level Results. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; 2007.
Cited by
Sorted by citations
International Consensus on Standardized Clinic Blood Pressure Measurement – A Call to Action
Cheung, A. K., Whelton, P. K., Muntner, P., Schutte, A. E., Moran, A. E., Williams, B., Sarafidis, P., Chang, T. I., Daskalopoulou, S. S., Flack, J. M., et al. (2023) · The American Journal of Medicine · doi:10.1016/j.amjmed.2022.12.015 · Cited by 96 · see citing works
“23,25,26 A systematic review of 328 articles found 29 components of the BP measurement procedure that can affect systolic BP (SBP) and diastolic BP (DBP) levels.”
Alfian, S. D., van Boven, J. F. M., Abdulah, R., Sukandar, H., Denig, P., & Hak, E. (2020) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.14610 · Cited by 46 · see citing works
“This can be partly explained by the wide intra-individual variability in blood pressure levels.(36,37) Therefore, the relationship between drug adherence and blood pressure control is difficult to demonstrate.”
BackgroundVariability independent of mean blood pressure as a real-world measure of cardiovascular risk
Ebinger, J. E., Driver, M. P., Ouyang, D., Botting, P. G., Ji, H., Rashid, M. A., Blyler, C. A., Bello, N. A., Rader, F., Niiranen, T., et al. (2022) · EClinicalMedicine · doi:10.1016/j.eclinm.2022.101442 · Cited by 54 · see citing works
Human Errors in Automated Office Blood Pressure Measurement: Still Room for Improvement
Elias, M. F., & Goodell, A. L. (2021) · Hypertension · doi:10.1161/hypertensionaha.120.16164 · Cited by 31 · see citing works
Effects of Different Rest Period Durations Prior to Blood Pressure Measurement: The Best Rest Trial
Brady, T., Charleston, J., Ishigami, J., Miller, E., Matsushita, K., & Appel, L. (2021) · HYPERTENSION · doi:10.1161/hypertensionaha.121.17496 · Cited by 29 · see citing works
“Exclusion criteria, mostly related to barriers to accurate BP measurement, were (1) rashes, casts, edema, paralysis, open sores or wounds, or arteriovenous shunts on both arms; (2) phlebotomy within last week; (3) cognitive impairment; (4) pregnancy; (5) midarm circumference >50 cm.”
BackgroundAl-Alusi, M., Friedman, S., Kany, S., Rämö, J., Pipilas, D., Singh, P., Reeder, C., Khurshid, S., Pirruccello, J., Maddah, M., et al. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01491-8 · Cited by 19 · see citing works
Todkar, S., Padwal, R., Michaud, A., & Cloutier, L. (2020) · Journal of Hypertension · doi:10.1097/hjh.0000000000002663 · Cited by 19 · see citing works
“The barriers for unsatisfactory practice include lack of time for health professionals to follow guidelines and lack of availability of electronic devices to measure BP [75,84].”
BackgroundBeger, C., Mayerböck, A., Klein, K., Karg, T., Schmidt-Ott, K., Randerath, O., & Limbourg, F. (2023) · Blood Pressure · doi:10.1080/08037051.2023.2165901 · Cited by 15 · see citing works
“Limited human and time capacities are most likely one of the major reasons for this general observation [24,25].”
Hayer, R., Kirley, K., Cohen, J., Tsipas, S., Sutherland, S., Oparil, S., Shay, C., Cohen, D., Kabir, C., & Wozniak, G. D. (2022) · The Journal of Clinical Hypertension · doi:10.1111/jch.14419 · Cited by 14 · see citing works
Assessment of blood pressure skills and belief in clinical readings
Gulati, M., Peterson, L.-A., & Mihailidou, A. (2021) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2021.100280 · Cited by 14 · see citing works
Ebinger, J., Driver, M. P., Huang, T.-Y., Magraner, J., Botting, P., Wang, M.-H., Chen, P.-S., Bello, N. A., Ouyang, D., Theurer, J., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-52406-8 · Cited by 13 · see citing works
Isolated systolic hypertension in young males: a scoping review
Scott, H., Barton, M., & Johnston, A. N. B. (2021) · Clinical Hypertension · doi:10.1186/s40885-021-00169-z · Cited by 21 · see citing works
“The heart rate and BP should be assessed twice in the first visit, 10 min apart, to improve accuracy [34].”
BackgroundZhang, L., Liang, H.-J., Luo, H., He, W.-J., Cai, Y.-Y., Liu, S.-Y., Fan, Y., Huang, W.-X., Zhao, Q., Zhong, D.-M., et al. (2023) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2023.100973 · Cited by 11 · see citing works
“43 Consistent with previous study, 44 we found primary care providers in economically developed provinces or higher-tier health institutions were more likely to comply with BP screening and measurement requirements, likely due to varying degrees of their knowledge gaps.”
ResultChapman, N., Jayasinghe, S., Moore, M. N., Picone, D. S., Schultz, M. G., Jose, M., McCallum, R. W., Armstrong, M. K., Peng, X., Marwick, T. H., et al. (2024) · Hypertension Research · doi:10.1038/s41440-024-01841-1 · Cited by 9 · see citing works
Elzeky, M. E. H., & Shahine, N. F. M. (2022) · BMC Nursing · doi:10.1186/s12912-022-01137-0 · Cited by 9 · see citing works
“This may be because accurate BPM is affected by many barriers [35] and organization awareness and designing interventions to overcome these barriers might be needed to alter staff behaviors and attitudes [36].”
BackgroundStergiou, G., Kyriakoulis, K., Kollias, A., McManus, R. J., Menti, A., Parati, G., Schutte, A., Wang, J.-G., Asayama, K., Asmar, R., et al. (2025) · Journal of Hypertension · doi:10.1097/hjh.0000000000003965 · Cited by 7 · see citing works
Perspectives of Primary Care Clinicians on the Diagnosis and Treatment of Pediatric Hypertension
Carroll, A. J., Mohanty, N., Wallace, A., Langman, C., & Smith, J. (2023) · Family & Community Health · doi:10.1097/fch.0000000000000358 · Cited by 7
Blood pressure measurement technique in clinical practice in the NHS Greater Glasgow and Clyde
Setjiadi, D., Geddes, C., & Delles, C. (2024) · Journal of Human Hypertension · doi:10.1038/s41371-024-00984-5 · Cited by 6
“What is known about the topic ● Blood pressure (BP) measurement is a common procedure conducted in various disciplines and widely available on clinical reports.”
Alpert, B. S., Schwartz, J. E., Shapiro, M., & Wexler, R. (2023) · EClinicalMedicine · doi:10.1016/j.eclinm.2023.102219 · Cited by 6 · see citing works
Shaver, N., Beck, A., Bennett, A., Wilson, B. J., Garritty, C., Subnath, M., Grad, R. M., Persaud, N., Thériault, G., Flemming, J. A., et al. (2024) · Systematic Reviews · doi:10.1186/s13643-023-02392-1 · Cited by 4 · see citing works
The Need for Accurate Data on Blood Pressure Measurement in the Dental Office
Elias, M., & Goodell, A. (2020) · American Journal of Hypertension · doi:10.1093/ajh/hpaa023 · Cited by 4 · see citing works
Evidence-Based, Streamlined Approach to Measure Blood Pressure in Primary Care Settings
Foti, K. E., Moran, A. E., Matsushita, K., Appel, L. J., Juraschek, S. P., Pathni, A. K., Banigbe, B., Dessie, G. A., Belbase, B., Bhuiyan, M. R., et al. (2025) · Hypertension · doi:10.1161/hypertensionaha.125.24527 · Cited by 3 · see citing works
“62,63 Further, the current approach to BP measurement that relies on averaging multiple measurements may not be practical in the field and is prone to error if the device used does not automatically calculate it, limiting opportunities for opportunistic screening.”
Ma, J., Tang, X.-F., Zhao, J., Zhang, J., Wang, Q., Wang, Y.-H., Yang, Q.-P., Shi, Y., Cheng, M.-N., Wang, Y., et al. (2024) · Hypertension Research · doi:10.1038/s41440-024-01687-7 · Cited by 3 · see citing works
Aje, A., & Adeyemo, J. O. (2023) · Discover Health Systems · doi:10.1007/s44250-023-00048-4 · Cited by 3 · see citing works
Cai, Q.-J., Zhao, X., Zhang, X., Wang, C., Zhou, Y., Tian, T., Zhou, X.-L., Zhang, Y.-Q., Liu, L., Zhang, W., et al. (2025) · Angiology · doi:10.1177/00033197251341775 · Cited by 2 · see citing works
Younis, M., Bhatti, K. I., Chachar, K., Nazir, P., Rafique, J. M., Khalid, A., Karera, S., Farooq, F., Hakeem, A., Saghir, T., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0308485 · Cited by 2 · see citing works
“Inaccurate or inconsistent measurement practices can result in mis-diagnosis, improper management, and ultimately, compromised patient outcomes [18].”
BackgroundMcDonagh, S. T. J., Sheppard, J. P., Warren, F. C., Boddy, K., Farmer, L., Shore, H., Williams, P., Lewis, P., Baumber, R., Fordham, J., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-040481 · Cited by 3 · see citing works
Monte Carlo simulation of uncertainty to identify barriers to optimizing blood pressure control
Zanisi, L., Floyd, C., Barrett, J. E., Bunce, C., Frohmaier, C., Shankar, F., & Chowienczyk, P. (2020) · Journal of Hypertension · doi:10.1097/hjh.0000000000002546 · Cited by 2
“There is an awareness among clinicians that measurement error can result in incorrect treatment decisions and that approaches to minimize error are important [14-16].”
BackgroundMeasuring blood pressure accurately
Mihailidou, A. (2026) · Australian Prescriber · doi:10.18773/austprescr.2026.016 · Cited by 1 · see citing works
Denny, M., Almohamad, M., Ebirim, E., Morell, A. S., Okpala, M., Hwang, K., Savitz, S. I., & Sharrief, A. (2025) · Journal of Stroke & Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2025.108282 · Cited by 1 · see citing works
Self-citationYousufuddin, M., Barkoudah, E., & Qayyum, R. (2023) · American Journal of Hypertension · doi:10.1093/ajh/hpad054 · Cited by 1 · see citing works
Brazilian health professionals’ perceptions and knowledge about automated blood pressure monitors
Albuquerque, N., Padwal, R., & Araujo, T. (2021) · Journal of Human Hypertension · doi:10.1038/s41371-021-00556-x · Cited by 1 · see citing works
Ensuring accurate BP measurements.
Matheson, E., Kremer, M. J., Fogg, L., & Crisanti, G. (2020) · Nursing · doi:10.1097/01.nurse.0000657040.45768.02 · Cited by 1
“The study concluded that multiple factors influenced the staff ’s ability to measure BP correctly.(15)”
BackgroundLai, X.-F., Dhar, S., Koob, C., Brackbill, E., Amrol, J., Garimella, S., Griffin, S. F., & Amati, J. B. (2026) · Journal of Public Health Management and Practice · doi:10.1097/phh.0000000000002500
Gastgivars, O., Ögren, J., Carlberg, B., & Brunström, M. (2026) · Journal of Internal Medicine · doi:10.1111/joim.70164
Patel, M. K., Timko-Swaim, L., Conklin, P., & Lu, W. (2026) · The Journal of Clinical Hypertension · doi:10.1111/jch.70234
“Utilizing a consistent and standard approach to measuring BP is crucial as numerous factors such as a patient’s physical state, the clinical setting, and the type of equipment used can easily lead to errors and result variability [ 11–13 ].”
Mutambara, J., Muleya, V., Nyoka, R., Matchaba-Hove, R., Nyamukapa, R., Magura, I., & Hungwe, C. (2025) · Ageing International · doi:10.1007/s12126-025-09637-5
“These findings are similar to studies by Chu et al. (2023) and Hwang et al. (2018).”
Aje, A., & Akinpelu, T. S. (2025) · Discover Health Systems · doi:10.1007/s44250-025-00223-9
“Not observing the precautions could serve as a barrier to accurate blood pressure measurement [19].”
Simulation-Based Assessment of Blood Pressure by Certified Athletic Trainers
Verde, M. W., Eberman, L., Emerson, D. M., Foster, Z. J., & Winkelmann, Z. K. (2025) · The Internet Journal of Allied Health Sciences & Practice · doi:10.46743/1540-580x.2752
“27 Improper patient positioning can lead to an increased chance of BP assessment errors.”
Zhernakova, Y., Rogoza, A., Kislyak, O., Blinova, N. V., Bragina, A., & Chazova, I. (2025) · Systemic Hypertension · doi:10.38109/2075-082x-2025-1-5-11
Getnet, M., Getahun, A., Bitew, D. A., & Getu, A. (2025) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2025.1436256
Alexander, M. R., Peterson, N., Kundu, S., Farber-Eger, E., Vongpatanasin, W., Freiberg, M., Wells, Q., Cook, P. A., & Beckman, J. A. (2024) · Vascular Medicine · doi:10.1177/1358863x241257140
“1,3,5 We found a lower systolic and diastolic BP with a second reading, consistent with prior studies.”
Naqvi, S., Potluri, P., Mandal, P., & Lewis, P. (2022) · Journal of the Textile Institute · doi:10.1080/00405000.2022.2124615
“It is the leading cause of poor health, disability and death (Daskalopoulou et al., 2015; Hwang et al., 2018; Staessen et al., 2017).”
BackgroundImproving the quality of blood pressure measurements in an outpatient diabetes clinic
Iyengar, J. J., Johnson, M., Khairi, S., Fennelly, J. E., & Wyckoff, J. (2021) · BMJ Open Quality · doi:10.1136/bmjoq-2020-000917
Vicent, B., Lilngulu, A., & Li, Y.-L. (2020) · doi:10.21203/rs.2.22073/v1
“Similar ndings have been documented by other studies [31].”
Result
- Authors
- Hwang, K. O., Aigbe, A., Ju, H.-H., Jackson, V. C., & Sedlock, E. W.
- Affiliations
- Memorial Hermann (US)
- The University of Texas Health Science Center at Houston (US)
- Corresponding author
- Hwang, Kevin O.
- Venue
- Journal of Primary Care & Community Health
- Publisher
- SAGE Publications
- Published
- 2018-01
- Volume
- 9
- Pages
- 2150132718816929-2150132718816929
- ISSN
- 2150-1319 (ISSN-L)
- 2150-1327
- PMC
- PMC6287289
- OpenAlex
- W2902551773
- Cited by
- 53
- References
- 26
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 9 · 2023: 12 · 2022: 5 · 2021: 7 · 2020: 7
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Primary Care & Community Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of Texas at Houston-Memorial Hermann Center for Healthcare Quality and Safety
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- blood pressure measurement, measurement error, primary health centers, outpatient care, blood pressure monitors, patient behavior, quality improvement
- MeSH terms
- Blood Pressure Determination, Diagnostic Errors, Humans, Hypertension, Interviews as Topic, Health Knowledge, Attitudes, Practice, Posture, Primary Health Care, Qualitative Research, Workflow
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
