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Cited by 44Blood Pressure and Hypertension StudiesMedication Adherence and ComplianceNon-Invasive Vital Sign Monitoring

Influence of ethnicity on acceptability of method of blood pressure monitoring: a cross-sectional study in primary care

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Wood, Sally, Greenfield, Sheila M, Sayeed Haque, M, Martin, Una, Gill, Paramjit S, Mant, Jonathan, Mohammed, Mohammed A, Heer, Gurdip +4 more·2016·British Journal of General Practice
DOI 10.3399/bjgp16x685717PMC PMC4979941
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Abstract

BACKGROUND: Ambulatory and/or home monitoring are recommended in the UK and the US for the diagnosis of hypertension but little is known about their acceptability. AIM: To determine the acceptability of different methods of measuring blood pressure to people from different minority ethnic groups. DESIGN AND SETTING: Cross-sectional study with focus groups in primary care in the West Midlands. METHOD: People of different ethnicities with and without hypertension were assessed for acceptability of clinic, home, and ambulatory blood pressure measurement using completion rate, questionnaire, and focus groups. RESULTS: A total of 770 participants were included, who were white British (n = 300), South Asian (n = 241), and African Caribbean (n = 229). White British participants had significantly higher successful completion rates across all monitoring modalities compared with the other ethnic groups, especially for ambulatory monitoring: white British (n = 277, 92% [95% confidence interval [CI] = 89% to 95%]) versus South Asian (n = 171, 71% [95% CI = 65% to 76%], P<0.001) and African Caribbean (n = 188, 82% [95% CI = 77% to 87%], P<0.001), respectively. There were significantly lower acceptability scores for minority ethnic participants across all monitoring methods compared with white British participants. Focus group results highlighted self-monitoring as most acceptable and ambulatory monitoring least acceptable without consistent differences by ethnicity. Clinic monitoring was seen as inconvenient and anxiety provoking but with the advantage of immediate professional input. CONCLUSION: Reduced acceptability and completion rates among minority ethnic groups raise important questions for the implementation and interpretation of blood pressure monitoring. Selection of method of blood pressure monitoring should take into account clinical need, patient preference, and potential cultural barriers to monitoring.

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Crossref · 10.3399/bjgp16x685717

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  • A recent systematic review showed that although accuracy of both office and home BP for diagnosis of hypertension has increased, ambulatory BP remains the most cost-effective option to confirm a diagnosis of hypertension.

    “A recent systematic review showed that although the accuracy of both office and home BP for the diagnosis of hypertension has increased, ambulatory BP remains the most cost-effective option to confirm a diagnosis of hypertension, an issue currently under debate [262].”

    From Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension (2021) · cites this paper as [262]

    The Introduction says ambulatory blood pressure monitoring is more accurate for diagnosing hypertension, and the Discussion (Comparison with existing literature) says home monitoring has only moderate diagnostic agreement with it. Neither passage says that office and home monitoring have become more accurate or that ambulatory monitoring is the most cost-effective way to confirm a diagnosis. The cited paper is a cross-sectional acceptability study, not the systematic review described in the claim. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Previously, measurement of asleep BP can only be achieved using ABPM, which can be expensive and is poorly tolerated by patients.

    “Previously, measurement of asleep BP can only be achieved using ABPM, which can be expensive and is poorly tolerated by patients. 60”

    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 [60]

    The Results (Acceptability and Ambulatory monitoring; page unavailable) show that ABPM was less acceptable than home or clinic monitoring and frequently disrupted sleep, supporting the poor-tolerance part of the claim. Our copy does not establish that ABPM was the only way to measure asleep BP or that it was expensive. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • BP-lowering benefit of HBPM has been greater when used with co-interventions (e.g. telemonitoring, pharmacist visits).

    “In fact, the BP-lowering benefit of HBPM has been greater when used with co-interventions (e.g. telemonitoring, pharmacist visits) [262].”

    From Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension (2021) · cites this paper as [262]

    The Results (Home monitoring; page unavailable) discuss participants’ preferences and perceived accuracy, while the Discussion (Comparison with existing literature; page unavailable) discusses diagnostic agreement and prognostic value. Searches for telemonitoring, pharmacist visits, and greater blood-pressure reduction with co-interventions found no passage addressing that comparison. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 1

  1. [25]National Institute for Health and Care Excellence Hypertension in adults: diagnosis and management CG127 2011 London NICE https://www.nice.org.uk/guidance/cg127 (accessed 13 May 2016) 31577399

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Authors
Wood, S., Greenfield, S. M., Sayeed Haque, M., Martin, U., Gill, P. S., Mant, J., Mohammed, M. A., Heer, G., Johal, A., Kaur, R., Schwartz, C., & McManus, R. J.
Affiliations
  • University of Oxford (GB)
  • University of Birmingham (GB)
  • University of Cambridge (GB)
  • University of Bradford (GB)
ORCID
Venue
British Journal of General Practice
Publisher
Royal College of General Practitioners
Published
2016-06-06
Volume
66
Issue
649
Pages
e577-e586
ISSN
  • 0960-1643 (ISSN-L)
  • 1478-5242
DOI
10.3399/bjgp16x685717
PMC
PMC4979941
OpenAlex
W2411804258
Cited by
44
References
35
Citations by year
2026: 2 · 2025: 6 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 9 · 2019: 6 · 2018: 1 · 2017: 4
FWCI
3.02
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • British Journal of General Practice (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bradford Scholars (University of Bradford) (acceptedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
  • Apollo (cc-by)
Funders
  • National Institute for Health and Care Research (CDF/01/017, NIHR-RP-02-12-015, PB-PG-1207-15042, NF-SI-0514-10121)
  • Research for Patient Benefit Programme
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Keywords
blood pressure monitoring, hypertension diagnosis, ambulatory blood pressure monitoring, clinic blood pressure measurement, acceptability, ethnic minorities, South Asian patients, Afro-Caribbean patients, patient preferences, cultural barriers to care
MeSH terms
Ambulatory Care Facilities, Antihypertensive Agents, Blood Pressure, Cross-Sectional Studies, England, Ethnicity, Female, Humans, Hypertension, Male, Middle Aged, Patient Acceptance of Health Care, Patient Care Management, Primary Health Care, Focus Groups, Blood Pressure Monitoring, Ambulatory

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