The potential for overdiagnosis and underdiagnosis because of blood pressure variability: a comparison of the 2017 ACC/AHA, 2018 ESC/ESH and 2019 NICE hypertension guidelines.

Abstract

The objective of this paper was to estimate the extent that BP measurement variability may drive over- and underdiagnosis of ‘hypertension’ when measurements are made according to current guidelines. Using data from the National Health and Nutrition Examination Survey and empirical estimates of within-person variability, authors simulated annual SBP measurement sets for 1 000 000 patients over 5 years. For each measurement set, they used an average of multiple readings, as recommended by guidelines.