[Skip to Content]
[Skip to Content Landing]
Views 4,990
Citations 0
Invited Commentary
October 12, 2020

A Tale of 2 Blood Pressures

Author Affiliations
  • 1Leon H. Charney Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York
  • 2Division of Healthcare Delivery Science, Department of Population Health, New York University Grossman School of Medicine, New York
  • 3Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
JAMA Intern Med. Published online October 12, 2020. doi:10.1001/jamainternmed.2020.5007

In this issue of JAMA Internal Medicine, Drawz et al1 report data from the Systolic Blood Pressure Intervention Trial (SPRINT) comparing office blood pressure (BP) measured in the trial with office BP obtained during routine clinical practice. SPRINT, which enrolled adults 50 years or older without diabetes or stroke to determine whether a more intensive BP treatment target was beneficial, was stopped early after an interim analysis showed that an office systolic BP (SBP) target of less than 120 mm Hg reduced cardiovascular events and all-cause mortality compared with a standard SBP target of less than 140 mm Hg.2 As in many hypertension trials, office BP was measured using a standardized protocol that included use of an oscillometric device and appropriately sized cuff along with a 5-minute period of rest before BP was measured, proper positioning of the participant, and measurement of and calculating the mean of 3 BP readings.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    1 Comment for this article
    EXPAND ALL
    Tale of Two Blood Pressures
    Thomas Shapiro, MD, MLA | Retired
    Blood pressure measurement especially in patients older than sixty Is quite variable. The morbidity end points of the Sprint Trial in this population study employing “research methods” were well defined and easy to document.
    Cardiovascular complications and stroke rates in this population were significantly correlated with successful reduction of systolic BP below 120 as compared with control rates below 140 systolic.
    Since in large populations, the difference between research method BP measurement and standard office measurement was modest and reduction of stroke rates were substantial, it suggests efforts to improve routine BP measurement is
    crucial. Surely “white coat hypertension” is an insufficient explanation for increased stoke rates in patients with office BP.
    CONFLICT OF INTEREST: None Reported
    READ MORE
    ×