First author and location | Year | Participants Total (male:female), Mean (SD) age | Measurement method | Randomised order of measurement | Blinding of doctors and nurses measurements | Blinding of outcome assessment | Summary risk of bias judgment | Notes |
---|---|---|---|---|---|---|---|---|
Bo38 Turin, Italy | 2008 | 224, (96:128) subjects attending lipid clinic, age 59.8 (13.2) years. 110 on antihypertensive treatment | Standard mercury sphygmomanometer and appropriately sized cuff. Mean of three consecutive readings after 5 minutes rest | No | Unclear | No | High | Same protocol for doctors and nurses |
Bo39 Turin, Italy | 2009 | 273 (109:164) patients age 72.6 (9.7) years. 84.2 on antihypertensive treatment, referred to hospital Alzheimer Evaluation Unit | Nurse readings obtained 15 minutes before and 10 minutes after physician readings using same protocol | No | Unclear | No | High | Nurse before doctor data extracted, nurse after doctor data not significantly different |
Culleton29 Calgary, Canada | 2006 | 107 (50:57) hypertensives age 57 (12) years referred for ABPM | Nurse measured BP twice, 5 minutes apart, after 5minutes rest, with mercury sphygmomanometer. Patients were seen within 3 hours by own family physician for a usual BP measurement | No | Yes | No | High | Probably different protocols: Doctors’ ‘usual measurement’ protocol not described |
de Blok30 Amsterdam, Netherlands | 1991 | 31 (13:17) patients with suspected hypertension age 43 years (range 17–63) referred to specialist hypertension clinic | Three readings collected after 5 minutes resting seated with random zero sphygmomanometer BP measurement by doctor and nurse in random order | Yes | Unclear | Yes | Low | Same protocol for doctors and nurses. Conference abstract only. Sex data do not = 100%; reported as stated in paper |
Gerin31 New York US | 2001 | 27 (9:18) patients age 57.6 (11.6) years attending hypertension clinic | Hawkesly random zero sphygmomanometer used by physicians and nurses to measure BP after 5 minutes rest seated. Mean of three measurements recorded at two visits 1 week apart | Unclear | Unclear | Yes | Low | Same protocol for doctors and nurses. Order of measurement was varied at visits; randomisation not described |
Gil28 Alicante Spain | 1994 | 50 (13:37) hypertensives in hospital clinic age 59.3 (7.9) years and 50 (23:27) years randomly selected non-hypertensive clinic attendees age 47.2 (10.1) years | BP measured by mercury sphygmomanometer after 5 minutes rest. Doctors measured BP first then nurses | No | Unclear | No | High | Same protocol for doctors and nurses. Spanish text English abstract: translated by CEC |
Kumpusalo25 Kuopio, Finland | 2002 | 148 (64:84) hypertensives age 59.2 years visiting one of six primary healthcare centres | BP measured twice with mercury sphygmomanometer and twice with Omrom HEM 705 (graded B/A by BHS). Means of all readings recorded | Yes | Unclear | Yes | Low | Same protocol for doctors and nurses Only doctor and nurse means from automated recordings extracted for analyses |
La Batide-Alanore32 Broussais Hospital, Paris | 2000 | 1062 (525:537) patients referred to hypertension clinic (2/3 on treatment). Age 51.8 (13.7) years | Nurses measured three BPs with 5-minute intervals using oscillometric device (Press Mate BP 880 Colin; graded B/B by BHS), patients lying supine. Then physicians measured BP with mercury sphygmomanometer after a mean of 15 minutes lying horizontally | No | Yes | No | High | Different measurement protocols for nurse and doctor |
Labinson et al.26 Connecticut, US | 2008 | 65 (29:36) African-American hypertensives age 53.6 (12.7) years recruited from primary care centre | Clinic BP measured x3 with mercury sphygmomanometer by white male study physician and white female study nurse. All wore white coats. Mean of three readings for each observer | Yes | Unclear | Unclear | Low | Same protocol for doctors and nurses. BP also measured by African–American male study physician (data not extracted), to assess effect of race of doctor |
Mansoor et al.33 University of Connecticut, US | 1996 | 64 hypertensives (23:41), mean age 65 (12) years; 59% on treatment referred to health centre for ABPM | Two BP readings with mercury sphygmomanometer, sitting after 10 minutes rest | Yes | Yes | Unclear | Low | Same protocol for doctors and nurses |
Richardson and Robinson37 London, England | 1971 | 372 men attending clinic for BUPA health screening | Nurses then doctors recorded supine BP within 1 hour with mercury sphygmomanometers | No | Unclear | No | High | Probably the same protocol for doctors and nurses |
Salvador et al.35 Toulouse, France | 1990 | 28 hypertensives (19:9), mean age 46 (12) years enrolled in study of β blockade on alerting reaction | Nurse measured BP with automated monitor seated after 10 minutes rest. Patients spent 12 minutes on an automated oscillometric monitor (data not extracted) then physician measured BP with mercury sphygmomanometer after 5 minutes rest | No | Unclear | No | High | Different measurement protocols for nurse and doctor. Original article in French; translated by CEC Model of automated sphygmomanometer not stated |
Sokolovic et al.36 Sarajevo, Bosnia Herzegovina | 2012 | 120 patients (35:85), mean age 47.2 years (No SD) recruited to a prospective clinical trial. Normotensive and hypertensive subgroups | BP first measured by physician then 15 minutes later by nurse | No | Unclear | Unclear | High | Poster abstract only, no further detail available. Authors contacted but no reply. SD imputed from matched studies |
Veerman and van Montfrans27 Amsterdam, Netherlands | 1992 | 110 consecutive patients with hypertension on treatment (55:55) mean age 46 (range 22–80) referred to specialist clinic for ABPM. | Patients seated quietly for 10 minutes had three readings made within 5 minutes with a Hawkesly random zero sphygmomanometer | Yes | Unclear | Yes | Low | Same protocol for doctors and nurses |
Yoon et al.34 Korea | 2010 | 1019 treated hypertensives (488:531) mean age 56 (10) from nine hospital clinics | BP measured with Omron HEM 747, mean of two measurements after 2 minutes rest seated | Unclear | Unclear | Yes | Low | Same protocol doctors and nurses. Hypertensives had no change of drugs in previous 6 months |
ABPM = Ambulatory blood pressure monitoring. BP = blood pressure.