Comparison of clinical blood pressure measurements to measurements according to guidelines in women admitted to the maternity ward for hypertension.

Abstract

Objective: To assess the adherence to recommended guidelines on measurement of blood pressure in obstetric clinical practice and to determine the difference in blood pressure values between observed clinical measurements and measurements strictly following recommended guidelines.   Methods: We assessed blood pressure of 60 women admitted to the maternity ward for a hypertensive disorder of pregnancy in pregnancy or postpartum. Blood pressure was measured by hospital staff according to usual clinical practice, and study personnel performed the measurement in accordance with international guidelines. Groups were compared using paired sample t-test and the Mantel-Haenszel test. Results: None of the clinical measurements fulfilled all recommended guidelines. Study systolic and diastolic readings were lower than those obtained in the usual clinical setting (systolic BP -7.0 mmHg (95% confidence interval: -9.2 to -4.8), p<0.001; diastolic BP -2.0 mmHg (95% confidence interval: -3.7 to -0.4), p=0.02). The risk of being categorized as hypertensive (≥140/90mmHg) decreased by 22% (95% confidence interval: 0.05-0.40, p=0.01) and 22/58 (38%) women shifted to a 10 mmHg category lower in systolic blood pressure along with 15/58 (26%) in diastolic blood pressure when measurements were performed by study personnel following recommended guidelines. Conclusion: Following recommended blood pressure measurement guidelines significantly lowers blood pressure readings and the risk of being categorized as hypertensive.   TWEETABLE ABSTRACT: Following recommended guidelines significantly decreases blood pressure readings and reduces the risk of being categorized as hypertensive in an obstetrical population.