Different measures of blood pressure in primary health care in Saudi Arabia

Khaled M. Hassan, Hadil E. Rahali, Hisham M. Balamash, Reem K. Alanazi, Naief S. Almatroudi, Munirah N. Alsairra, Anfal H. Alhobera, Abdullah H. Alhobera, Ahmed A. Alolah, Ali A. Shok, Mohammed A. Althumairy, Shaima M. Alghuraybi, Mariyah J. Alkhabbaz, Mohammed A. Alasmari, Mohammad S. AlMabouth, Ibtihal M. Aldrees


Background: Objective of the study was to be able to know various measurement or devices for blood pressure (BP) used in primary care (PC).

Methods: Cross-sectional multicenter study, sample is consecutive cases, study done in kingdom of Saudi Arabia in health institution of Primary care that treat patients who already diagnosed with hypertension aged more than 18 years old, the method used in the study is observation of devices which measure blood pressure through two following BP measurements.

Results: Blood pressure was measured for 14,137 from 3,592 PC physicians, blood pressured measured by a mercury sphygmomanometer, in 69.8% of the patients, while it is measured by electronic device in 16.5% but measured by aneroid manometer in 11.8% while 1.9% measured by more of a measurement method. Electronic devices and aneroid manometers were the most used measurement of blood pressure in rural areas. Also, there were differences in the BP values between different methods of the measurement.  

Conclusions: The best methods of blood pressure measurement between medical staff is mercury sphygmomanometers and aneroid devices in primary care and to avoid biases in the measurement we encourage to use electronic devices to measure BP.


High blood pressure, Measurement devices, Primary care

Full Text:



McGovern PG, Pankow JS, Shahar E, Doliszny KM, Folsom AR, Blackburn H, et al. The Minnesota Heart Survey Investigators. Recent trends in acute coronary heart disease: mortality, morbidity, medical care, and risk factors. N Engl J Med. 1996;334:884-9

Joint National Committee. The fifth report of the Joint National Committee on detection, evaluation, and treatment of high blood pressure (JNC V). Arch Intern Med. 1993;153:154-83.

Blood pressure as a major risk factor for cardiovascular disease: the Framingham Study. 30 years of follow-up. Hypertens.1989;13:13-8.

Kannel WB. Blood pressure as a cardiovascular risk factor: prevention and treatment. J Americ Medic Assoc. 1996;1571-6.

Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and dyastolic, and cardiovascular risk of fatal coronary heart disease. Arch Inter Med. 1993;5:598-615.

MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, et al. Blodd pressure, stroke and coronary heart disease. Lancet. 1990;765-74.

Vinyoles E, Armengol F, Bayo J, Mengual L, Salvado A, Pepió JM, Representing the Hypertension Group of the Catalan Society of Family Medicine in the Community. Med Clin (Barc). 2003;120(12):460-3.

Divisón JA, Puras A, Sanchis C, Artigao LM, López Abril J, López CE, et al. Exactity and precision in the middle of the arterial pressure. Comparative study of home automation services with the help of consultation and outpatient monitoring. Aten Primaria. 2001;5:299-307.

Anderson KM, Odell PM, Wilson PWF, Kannel WB. Cardiovascular disease risk profiles. Am Heart J. 1991;121:293-8.

O'Brien E, Waeber B, Parati G, Staessen J, Myers MG. Blood pressure measuring devices: recomendatios of the European Society of Hypertension. Britis Med J. 2001;322(7285):531-6.

Chatellier G, Dutrey-Dupagne C, Vaur L, Zannad F, Genes N, Elkik F, et al. Home self-blood pressure measurement in general practice. The SMART study. Am J Hypertens. 1996;9:644-52.

Mion D, Pierin AMG. How accurate are sphygmomanometers? J Hum Hypertens. 1998;12:245-8.

Cupples LA. Section 34: some risk factors related to the annual incidence of cardiovascular disease and death in pooled repeated biennial measurements. Framingh Hear Stud 30 Year Follow. Foll Up. 1987: 1-22.

Harrell FE Jr, Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996;15:361-3

O'Rorke JE, Richardson WS. What to do when blood pressure is difficult to control. Brit Med J. 2001;322.

Pickering TG. What will replace the mercury sphygmomanometer? Blood Press Monit. 2003;8:23-5.