Practice and awareness of physicians regarding casual-clinic blood pressure measurement in Japan

Abstract

The optimal procedure for casual-clinic blood pressure (CBP) measurement is outlined in the 2004 Japanese guidelines. We investigated the status of physicians' practices and their awareness of CBP measurement immediately and 4 years after the publication of the guidelines using a questionnaire regarding CBP. This survey was conducted among physicians who attended educational seminars on hypertension in 2004-2005 and in 2007-2008; the questionnaire was distributed, completed and collected just before the start of the seminars. Of the 1966 respondents to the 2004-2005 survey and the 2995 respondents to the 2007-2008 survey, the proportion of physicians who answered that CBP was more important than self-measured BP at home (home BP) was less than 10% in both surveys. The proportion of physicians who used a mercury sphygmomanometer (68.1-75.5%) was higher than those who used an automatic and electronic sphygmomanometer (20.7-29.0%) in both surveys. However, the use of an automatic and electronic sphygmomanometer slightly increased from 20. Keywords: casual-clinic blood pressure; guidelines; physicians INTRODUCTION Blood pressure (BP) is a major vital sign used to evaluate the physical condition of each patient. Measurement of casual-clinic BP (CBP) in clinical settings has been used as the gold standard for hypertension evaluation. Under the Japanese guidelines for the management of hypertension, the optimum conditions for CBP measurement include the use of the auscultation method, with a mercury or aneroid sphygmomanometer for the measurement of CBP, or the use of an automatic sphygmomanometer that has been calibrated. 1,2 Previous reports have shown that CBP, as measured in strict accordance with the procedures set forth in the guidelines, had a clinical value at least comparable with BP measured in out-of-clinical settings, 3 although BP measured in out-of-clinical settings has several advantages, including the avoidance of both observer bias and the white-coat effect. 4,5 Therefore, in clinical trials and epidemiological surveys, CBP has often

Long-Term Stroke Risk Due to Partial White-Coat or Masked Hypertension Based on Home and Ambulatory Blood Pressure Measurements

“…In this regard, however, even 2 blood pressure measurements during each office visit are not necessarily performed by physicians in a general medical practice. [35][36][37] Finally, we did not collect information on nonfatal ischemic heart disease. The association between the hypertension groups and death from ischemic heart disease did not differ largely from that of stroke events in the present study (Table S7).…”

The reason why home blood pressure measurements are preferred over clinic or ambulatory blood pressure in Japan

“…BP is rarely measured in accordance with such guidelines in a screening or clinical setting, and worries about the accuracy of measurements are often disregarded or ignored. 1,8,64 The challenges of low compliance with the procedure of CBPM remains, at least in Japan. 64 Accuracy of devices HBP and ABP are measured by automatic devices based predominantly on the cuff-oscillometric principle.…”

“…1,8,64 The challenges of low compliance with the procedure of CBPM remains, at least in Japan. 64 Accuracy of devices HBP and ABP are measured by automatic devices based predominantly on the cuff-oscillometric principle. Issues with the accuracy of the automatic devices remain.…”

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

“…A recent survey of family physicians in Canada found that despite the emphasis placed by Canadian HT guideline on the use of ABPM and AOBP, only 14.4% participants used ABPM for diagnosing HT (17). Other similar studies had small sample-sizes, or were older (18)(19)(20).…”