Blood pressure measurement device change in the Healthy Finland health examination survey

BACKGROUND: Blood pressure (BP) measurements in health examination surveys (HESs) are needed for public health monitoring. In Finland, population-based HESs with BP measurements have been performed with mercury sphygmomanometers since the 1960's. The use of oscillometric devices has rendered sphygmomanometers impractical for health surveys. This study describes the change in BP measurement method and mean BP values in Finnish HESs. METHODS: 66 000 randomly selected adults living in Finland were invited to the Healthy Finland questionnaire-based health survey in 2022-2023. Of those, 10 000 were asked to participate in a HES including BP, anthropometric, and functional capacity measurements as well as collection of biological samples. Prior to the selection of the new oscillometric BP device, validation studies for devices were evaluated, and the availability was checked. BP measurements were performed using WatchBP Office Vascular (TWIN200 VSR) device. RESULTS: Two consecutive BP measurements were obtained from 3424 participants aged 30 years or older (ongoing until 6/2023). The mean (95% CI) systolic blood pressures (SBP) for men and women were 137.1 (136.2-140.0) and 134.7 mmHg (133.7-135.6), respectively. The corresponding values for diastolic blood pressure (DBP) were 82.3 (81.8-82.8) and 79.3 mmHg (78.9-79.8). The mean difference (95% CI) between the 1st and the 2nd SBP measurements were -2.4 (-2.7- -2.0) and -1.8 (-2.1- -1.4) in men and women, while the corresponding values for DBP were -1.1 (-1.4- -0.9) and -1.2 (-1.5- -1.0). Distribution of measurements was Gaussian apat from some values, that were unlikely to be obtained (SBP: 155, 156, 157; DBP: 96, 99). CONCLUSIONS: Oscillometric BP provide reliable data in HESs. Finnish BP levels may be on the rise. Further reseach is needed to estimate the effects of gaps in the measurement algorithm of TWIN200 VSR and the differences in consecutive measurements. KEY MESSAGES: • In a health examination survey, oscillometric blood pressure measurements led to similar results as with a sphygmomanometer. • Algorithm gaps and smaller difference on successive measurements were seen.