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Cited by 22Blood Pressure and Hypertension StudiesClinical practice guidelines implementationPrimary Care and Health Outcomes

Preference of blood pressure measurement methods by primary care doctors in Hong Kong: a cross-sectional survey

Open access
Lee, Eric Kam Pui, Choi, Ryan Chun Ming, Liu, Licheng, Gao, Tiffany, Yip, Benjamin Hon Kei, Wong, Samuel Yeung Shan·2020·BMC Family Practice
DOI 10.1186/s12875-020-01153-6PMC PMC7251842

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Abstract

Background: Hypertension is the most common chronic disease and is the leading cause of morbidity and mortality. Its screening, diagnosis, and management depend heavily on accurate blood pressure (BP) measurement. It is recommended that the diagnosis of hypertension should be confirmed or corroborated by out-of-office BP values, measured using ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). When office BP is used, automated office BP (AOBP) measurement method, which automatically provides an average of 3–5 BP readings, should be preferred. This study aimed to describe the BP measurement methods commonly used by doctors in primary care in Hong Kong, to screen, diagnose, and manage hypertensive patients. Methods: In this cross-sectional survey, all doctors registered in the Hong Kong “Primary Care Directory” were mailed a questionnaire, asking their preferred BP-measuring methods to screen, diagnose, and manage hypertensive patients. Furthermore, we also elicited information on the usual number of office BP or HBPM readings obtained, to diagnose or manage hypertension. Results: Of the 1738 doctors included from the directory, 445 responded. Manual measurement using a mercury or aneroid device was found to be the commonest method to screen (63.1%), diagnose (56.4%), and manage (72.4%) hypertension. There was a significant underutilisation of ABPM, with only 1.6% doctors using this method to diagnose hypertension. HBPM was used by 22.2% and 56.8% of the respondents to diagnose and manage hypertension, respectively. A quarter (26.7%) of the respondents reported using only one in-office BP reading, while around 40% participants reported using ≥12 HBPM readings. Doctors with specialist qualification in family medicine were more likely to use AOBP in clinics and to obtain the recommended number of office BP readings for diagnosis and management of hypertension. Conclusion: Primary Care doctors in Hong Kong prefer to use manual office BP values, measured using mercury or aneroid devices, to screen, diagnose, and manage hypertension, highlighting a marked underutilisation of AOBP and out-of-office BP measuring techniques, especially that of ABPM. Further studies are indicated to understand the underlying reasons and to minimise the gap between real-life clinical practice and those recommended, based on scientific advances. Trial registration: Clinicaltrial.gov; ref. no.: NCT03926897 .

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  • In the current review, only 2 RCTs comprising of 80 participants used AOBP.

    “However, AOBP remains uncommonly used by clinicians and in research; and in the current review, only 2 RCTs comprising of 80 participants used AOBP. 54,55”

    From Effect and Acceptability of Mindfulness-Based Stress Reduction Program on Patients With Elevated Blood Pressure or Hypertension: A Meta-Analysis of Randomized Controlled Trials (2020) · cites this paper as [54]

    The Results (BP screening; page unavailable) report that only 13.7% of surveyed Hong Kong primary care doctors used AOBP for hypertension screening, supporting uncommon clinical use in that setting. The paper is a cross-sectional survey, not the citing authors’ review; it does not report that two RCTs with 80 participants used AOBP or establish how commonly AOBP is used in research. (LLM, conf=0.88)

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Authors
Lee, E. K. P., Choi, R. C. M., Liu, L., Gao, T., Yip, B. H. K., & Wong, S. Y. S.
Affiliations
Chinese University of Hong Kong (HK)
Corresponding author
Lee, Eric Kam Pui
ORCID
Venue
BMC Family Practice
Publisher
Springer Science and Business Media LLC
Published
2020-05-26
Volume
21
Issue
1
Pages
95-95
ISSN
1471-2296 (ISSN-L)
DOI
10.1186/s12875-020-01153-6
PMC
PMC7251842
OpenAlex
W3032709858
Cited by
22
References
32
Citations by year
2026: 3 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 1
FWCI
2.16
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Family Practice (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
blood pressure measurement, hypertension diagnosis, ambulatory blood pressure monitoring, home blood pressure monitoring, automated office blood pressure, primary care physicians, hypertension screening, antihypertensive therapy, general practice, Hong Kong
MeSH terms
Procedures and Techniques Utilization, Cross-Sectional Studies, Female, Hong Kong, Humans, Hypertension, Male, Middle Aged, Office Visits, Primary Health Care, Blood Pressure Monitoring, Ambulatory, Sphygmomanometers, Patient Preference, Dimensional Measurement Accuracy

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