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Abstract: TH-PO226

A Multicentre Audit of Standardised Office Blood Pressure Measurement in Ireland

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Nic an Riogh, Eithne Muireann, Mater Misericordiae University Hospital, Dublin, Ireland
  • Anees, Anees, Mater Misericordiae University Hospital, Dublin, Ireland
  • Redahan, Lynn, Mater Misericordiae University Hospital, Dublin, Ireland
  • O'Meara, Yvonne M., Mater Misericordiae University Hospital, Dublin, Ireland
  • Ward, Frank, Tallaght University Hospital, Dublin, Dublin, Ireland
  • Sadlier, Denise M., Mater Misericordiae University Hospital, Dublin, Ireland

Hypertension is a common comorbidity of chronic kidney disease (CKD) and increases the risk of cardiovascular disease, end-stage kidney disease and death. The KDIGO 2021 Clinical Practice Guideline on the Management of Blood Pressure in CKD recommends a target systolic blood pressure (BP) target <120 mmHg in adults with CKD. Importantly, the guideline distinguishes between routine and standardised office BP measurement with the latter more likely to be an accurate measure of BP. In this study, adherence to standardised office BP measurement was assessed in busy nephrology outpatient clinics in two hospitals.


The KDIGO guidelines describe eighteen criteria to achieve standardised office BP measurement (e.g. patient sitting relaxed >5 mins, avoidance of caffeine/tobacco in 30 minutes prior to BP measurement, position of BP cuff). Adherence to these criteria was prospectively assessed by direct observation of BP measurements. Basic demographics and BP data from patients attending nephrology outpatient departments in two Dublin teaching hospitals were collected electronically. Adherence to 18 criteria was assessed using descriptive statistics. This audit is now expanding to include cardiology clinics as well as a questionnaire to assess patient awareness of hypertension.


From January 2022–2023, 308 patients were recruited. Of the 18 criteria assessed, 6 had an adherence of > 90% and 5 criteria had an adherence of <10%. Areas with poorest compliance included supporting the arm during BP measurement 18.2% (n=56), averaging >/= 2 readings 0.3% (n=1) and noting the time antihypertensive medication was last taken 2.3 % (n=7). Measurement of BP in both arms at the initial visit was not carried out for any patients. The mean BP was 136/72 mmHg and Systolic BP <20 mmHg was achieved in 22% (n=33) patients. Clinical practice was similar across both sites other than a statistically significant difference in practice: informing patients of their BP verbally (99.3% vs 12%, P <0.001) and in writing (100% vs 1.9%, p <0.001).


Current clinic BP measurement does not meet the definition of standardised office BP measurement as outlined by KDIGO. However, simple changes to clinical practice could be implemented through education to significantly improve BP measurement as a more accurate measure of treatment response.