Letter by Messerli et al Regarding Article, “The Implications of Blood Pressure Measurement Methods on Treatment Targets for Blood Pressure”
To the Editor:
In an attempt to clarify the implications of blood pressure (BP) measurement methods on treatment targets, Bakris1 states that in SPRINT (Systolic Blood Pressure Intervention Trial),2 BP was measured “after the participant sat quietly alone for 5 minutes, after which study personnel returned to the room to measure BP 3 times at 1 minute intervals with all 3 values averaged.”2 This approach is in sharp contradiction to the methodology slide presented at the yearly meeting of the European Society of Cardiology in Rome on August 28, 2016, by Cushman, one of the principal investigators of SPRINT. According to Bakris,1 BP measurements were witnessed, whereas according to Cushman,3 the device was set and “research staff was trained to push start button and leave examination room during the 5 minutes delay and measurements” (our italics). Because the clinical implications of SPRINT and its usefulness for the practicing physician (and for prospective hypertension guidelines) stand and fall with the methodology of BP measurements,4,5 the question of whether these measurements were witnessed urgently needs to be clarified. Perhaps we should resort to polling the 102 research coordinators of SPRINT who had hands on and recorded BP at least 422 367 times throughout the study on more than 140 789 occasions. We are confident that they will be able to recall exactly how the BP was measured.
Dr Messerli has consultant or advisory relationships with Daiichi-Sankyo, Pfizer, Abbott, Servier, Medtronic, WebMD, Ipca, ACC, Menarini, Relypsa, and University of Utah. Dr Kjeldsen has received honoraria from ABDiiBRAHiM, Bayer, MSD, and Takeda for lecturing and consultancy.
Circulation is available at http://circ.ahajournals.org.
- © 2017 American Heart Association, Inc.
- Bakris GL.
- Cushman WC.
- Kjeldsen SE,
- Lund-Johansen P,
- Nilsson PM,
- Mancia G.
- Messerli FH,
- Bangalore S.