Hypertension Prevalence Based on Blood Pressure Measurements on Two vs. One Visits: A Community-Based Screening Programme and a Narrative Review

We assessed the difference in the prevalence of hypertension in community surveys when blood pressure (BP) was measured on two vs. one visits and its impact on hypertension awareness, treatment and control proportions. A community-based BP screening programme was conducted in public places in the Seychelles (619 adults) and BP was rechecked a few days later among untreated participants with high BP (≥140/90 mmHg). A narrative review of the literature on this question was also conducted. Only 64% of untreated participants with high BP still had high BP at the second visit. The prevalence of hypertension in the whole sample decreased by 13% (from 33.8% to 29.5%) when BP was measured on two vs. one visits. These results concurred with our findings in our narrative review based on 10 surveys. In conclusion, the prevalence of hypertension can be markedly overestimated in community surveys when BP is measured on two vs. one visits. The overestimation could be addressed by measuring BP on a second visit among untreated individuals with high BP or, possibly, by taking more readings at the first visit. These findings have relevance for clinical practice, policy and surveillance.