Table 1.
Methodology of blood pressure measurement in major hypertension trials
| Study acronym [ref], year of publication | Observer | Device description | Measurements, n | Time interval between measurements | Resting period | Position(s) | Arm | Cuff | Drug timinga |
|---|---|---|---|---|---|---|---|---|---|
| SHEP [4, 5], 1991 | Trained, certified technician | Random-zero sphygmomanometer | Average of 4 readings (twice at each of the 2 visits) | 30 s | After 5 min of seated rest and 1–3 min of standing | Seated and standing | Right arm | Appropriate size | – |
| STOP-H [6, 7], 1991 | Nurse or doctor | Mercury sphygmomanometer | Average of 2 readings | – | After 5 min in supine position and 1–3 min standing | Supine and standing | – | Appropriate size | – |
| MRC old [8], 1992 | Nurse and/or doctor | Random zero sphygmomanometer | Average of the 2nd and the 3rd of 3 readings | – | – | Seated | – | – | – |
| TOMHS [9, 10], 1993, 1991 | Trained, certified, and monitored observer | Random zero sphygmomanometer | Average of 2 readings | 30 s | After 5 min of rest | Seated | Right arm | Appropriate size | Morning blood pressure 1–4 h after medication |
| SYST-EUR [11, 12], 1997, 1991 | Mercury sphygmomanometer | Average of 6 sitting and 6 standing readings (2 in each position at each of the 3 visits) | After 2, 5, and 2 min of rest in supine, seated, and standing positions, respectively | Seated, supine, and standing | – | – | – | ||
| SYST-China [13, 14], 1998 | Physician | Mercury sphygmomanometer | Average of 6 readings (twice at each of the 3 visits) | 1 min | After 5 and 2 min of rest seated and standing, respectively | Seated | – | – | At troughb |
| HOT [15, 16], 1998, 2001 | – | Oscillometric semiautomatic device | 3 readings | – | After 5 min of rest | Seated | – | – | – |
| NICS-EH [17], 1999 | – | – | – | – | – | – | – | – | – |
| CAPPP [18], 1999 | – | Mercury sphygmomanometer | Average of 3 readings | – | – | Supine | – | Appropriate size | – |
| NORDIL [19], 2000 | – | – | Single reading at each of at least 2 visits | – | After 10 min of rest | Seated | – | – | – |
| INSIGHT [20, 21], 2000 | – | Mercury sphygmomanometer | Average of 3 readings | – | After 5 min of rest | – | – | – | At troughb |
| PROGRESS [22, 23], 2001, 1996 | Trained observer | Mercury sphygmomanometer | Average of 2 readings | 2 min | After 5 min of rest | Seated | – | – | – |
| IDNT [24], 2000 | – | – | – | – | – | Seated | – | – | – |
| HOPE [25, 26], 2001, 2000 | – | Mercury sphygmomanometer | Average of 2 readings on each arm | – | – | – | Arm with higher BP | – | – |
| Study acronym [ref], year of publication | Observer | Device description | Measurements, n | Time interval between measurements | Resting period | Position(s) | Arm | Cuff | Drug timinga |
| LIFE [27, 28], 2002, 1997 | – | Validated, calibrated manual manometer | Average of 2 readings | 1 min | After 5 min of rest | Seated and standing | Right or left arm | Appropriate size | At trough (22–26 h) |
| ALLHAT [29, 30], 2002, 2001 | Trained observer | – | Average of 2 readings | 30 s | – | Seated | – | – | – |
| ANBP 2 [31, 32], 2003, 1997 | Trained study nurse | Mercury sphygmomanometer | Average of the 2nd and 3rd of 3 readings if blood pressure difference <10/6 mm Hg between readings | – | After 5 min of rest | Seated | – | Appropriate size | – |
| SCOPE [33, 34], 2003, 1999 | – | – | Average of the 2nd and the 3rd of 3 readings | 1 min | After 5–10 min of rest | Seated and standing | – | Appropriate size | – |
| INVEST [35, 36], 2003, 1998 | – | Mercury sphygmomanometer, calibrated aneroid manometer, or validated electronic device | Average of 2 readings; additional readings if difference >5 mm Hg between readings | 2 min | After 5 min of rest | Seated | Right or left arm | Appropriate size | |
| VALUE [37], 2004 | – | – | – | – | After 5 min of rest | Seated | – | – | At trough (24 h after the dose) |
| ASCOT-BPLA [39, 40], 2005, 2001 | – | Semiautomated device (Omron HEM 705CP) | Average of the 2nd and 3rd of 3 readings | – | After 5 min of rest | Seated | – | – | All drugs taken no more than 24 h before study visits |
| FEVER [41], 2005 | – | Mercury sphygmomanometer | Average of 3 readings | 1 min | After 5 and 2 min of rest seated and standing, respectively | Seated and standing | – | Appropriate size | – |
| E-COST [42], 2005 | – | – | Average of readings | – | – | Seated | – | – | At troughb |
| ADVANCE [43], 2007 | – | Standardized automated (Omron HEM-705CP) | Average of 2 readings | – | After 5 min of rest | Seated | – | – | – |
| AVOID [44], 2008 | – | Mercury sphygmomanometer | Average of 3 readings | 2 min | After 5 min of rest | – | – | Appropriate size | At troughb |
| ONTARGET [45, 46], 2008, 2004 | – | Semiautomatic validated device (OMRON HEM-757) | Average of 2 readings | – | After 3 min of rest | Seated | – | – | – |
| ACCOMPLISH [47, 48], 2008, 2004 | – | – | Average of 3 readings | 2 min | After 5 min of rest | Seated | – | – | – |
| Study acronym [ref], year of publication | Observer | Device description | Measurements, n | Time interval between measurements | Resting period | Position(s) | Arm | Cuff | Drug timinga |
| JATOS [49], 2005 | – | Sphygmomanometer | Average of at least 2 readings per visit | – | After 5–10 min of rest | Seated | – | – | – |
| CASE-J [50], 2008 | – | – | Average of 2 readings | – | – | Seated | – | – | – |
| HIJCREATE [51], 2009 | – | Mercury sphygmomanometer | – | – | After 5 min of rest | Seated | – | – | – |
| ACCORD BP [52, 53], 2010, 2007 | – | Automated blood pressure monitor (Omron 907) | Average of 3 readings | – | – | Seated | – | – | – |
| COPE [54], 2011 | Physician | – | Average of 2 stable readings | 1–2 min | After 5 min of rest | Seated | – | – | – |
| OSCAR [55, 56], 2012, 2009 | – | Mercury or automatic sphygmomanometer | Single reading at 2 different visits | – | – | Seated | – | – | – |
| NAGOYA HEART [57], 2010 | – | – | Single reading at each of at least 2 visits | – | – | – | – | – | – |
| SPRINT [58], 2017 | Unattended | Automated manometer (Omron 907) | Average of 3 readings | 1 min | After 5 min of rest | Seated | – | Proper cuff size | – |
| HOPE-3 [59, 60], 2016 | – | Automatic blood pressure monitor (Omron HEM-711DLXCAN) or mercury sphygmomanometer | Average of 2 readings | At least 1 min | After 5 min of rest | Seated | Right arm | Evenly tight | – |
a
Timing of the blood pressure measurement in relation to the last medication dosage.
b
”Trough” usually refers to blood pressure measured 20–26 h after the last study medication was taken.