{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:28:19Z","timestamp":1787020099800,"version":"build-2736575974"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T00:00:00Z","timestamp":1590451200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T00:00:00Z","timestamp":1590451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Fam Pract"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertension is the most common chronic disease and is the leading cause of morbidity and mortality. Its screening, diagnosis, and management depend heavily on accurate blood pressure (BP) measurement. It is recommended that the diagnosis of hypertension should be confirmed or corroborated by out-of-office BP values, measured using ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). When office BP is used, automated office BP (AOBP) measurement method, which automatically provides an average of 3\u20135 BP readings, should be preferred. This study aimed to describe the BP measurement methods commonly used by doctors in primary care in Hong Kong, to screen, diagnose, and manage hypertensive patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional survey, all doctors registered in the Hong Kong \u201cPrimary Care Directory\u201d were mailed a questionnaire, asking their preferred BP-measuring methods to screen, diagnose, and manage hypertensive patients. Furthermore, we also elicited information on the usual number of office BP or HBPM readings obtained, to diagnose or manage hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1738 doctors included from the directory, 445 responded. Manual measurement using a mercury or aneroid device was found to be the commonest method to screen (63.1%), diagnose (56.4%), and manage (72.4%) hypertension. There was a significant underutilisation of ABPM, with only 1.6% doctors using this method to diagnose hypertension. HBPM was used by 22.2% and 56.8% of the respondents to diagnose and manage hypertension, respectively. A quarter (26.7%) of the respondents reported using only one in-office BP reading, while around 40% participants reported using \u226512 HBPM readings. Doctors with specialist qualification in family medicine were more likely to use AOBP in clinics and to obtain the recommended number of office BP readings for diagnosis and management of hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Primary Care doctors in Hong Kong prefer to use manual office BP values, measured using mercury or aneroid devices, to screen, diagnose, and manage hypertension, highlighting a marked underutilisation of AOBP and out-of-office BP measuring techniques, especially that of ABPM. Further studies are indicated to understand the underlying reasons and to minimise the gap between real-life clinical practice and those recommended, based on scientific advances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Clinicaltrial.gov; ref. no.:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03926897?term=NCT03926897&amp;draw=2&amp;rank=1\">NCT03926897<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12875-020-01153-6","type":"journal-article","created":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T16:02:37Z","timestamp":1590508957000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Preference of blood pressure measurement methods by primary care doctors in Hong Kong: a cross-sectional survey"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8267-9384","authenticated-orcid":false,"given":"Eric Kam Pui","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan Chun Ming","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin Hon Kei","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Yeung Shan","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,26]]},"reference":[{"key":"1153_CR1","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1161\/CIRCULATIONAHA.115.018912","volume":"134","author":"KT Mills","year":"2016","unstructured":"Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control. Circulation. 2016;134:441\u201350.","journal-title":"Circulation"},{"key":"1153_CR2","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/S0140-6736(14)61682-2","volume":"385","author":"M Naghavi","year":"2015","unstructured":"Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;385:117\u201371.","journal-title":"Lancet"},{"key":"1153_CR3","unstructured":"National Institute for Clinical Excellence. Hypertension in adults: diagnosis and management. NICE Clin Guidel. 2017. https:\/\/www.nice.org.uk\/guidance\/ng136."},{"key":"1153_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/hr.2014.149","volume":"38","author":"M Gorostidi","year":"2015","unstructured":"Gorostidi M, Vinyoles E, Banegas JR, De La Sierra A. Prevalence of white-coat and masked hypertension in national and international registries. Hyperten Res. 2015;38:1\u20137.","journal-title":"Hyperten Res"},{"key":"1153_CR5","doi-asserted-by":"publisher","first-page":"192","DOI":"10.7326\/M14-1539","volume":"162","author":"MA Piper","year":"2015","unstructured":"Piper MA, Evans CV, Burda BU, Margolis KL, O\u2019Connor E, Whitlock EP. Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. preventive services task force. Ann Intern Med. 2015;162:192\u2013204.","journal-title":"Ann Intern Med"},{"key":"1153_CR6","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1161\/01.HYP.0000160402.39597.3b","volume":"45","author":"TW Hansen","year":"2005","unstructured":"Hansen TW, Jeppesen J, Rasmussen S, Ibsen H, Torp-Pedersen C. Ambulatory blood pressure and mortality: a population-based study. Hypertension. 2005;45:499\u2013504.","journal-title":"Hypertension"},{"key":"1153_CR7","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1161\/HYPERTENSIONAHA.110.150771","volume":"55","author":"GS Stergiou","year":"2010","unstructured":"Stergiou GS, Siontis KCM, Ioannidis J. Home blood pressure as a cardiovascular outcome predictor: It\u2019s time to take this method seriously. Hypertension. 2010;55:1301\u20133.","journal-title":"Hypertension"},{"issue":"9798","key":"1153_CR8","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1016\/S0140-6736(11)61184-7","volume":"378","author":"Kate Lovibond","year":"2011","unstructured":"Lovibond K, Jowett S, Barton P, Caulfield M, Heneghan C, Hobbs FDR, et al. Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study. Lancet. 2011;378:1219\u201330. http:\/\/www.nice.org.uk\/guidance\/ng136.","journal-title":"The Lancet"},{"key":"1153_CR9","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1161\/HYPERTENSIONAHA.118.11715","volume":"73","author":"H Beyhaghi","year":"2019","unstructured":"Beyhaghi H, Viera AJ. Comparative cost-effectiveness of clinic, home, or ambulatory blood pressure measurement for hypertension diagnosis in US adults. Hypertension. 2019;73:121\u201331.","journal-title":"Hypertension"},{"key":"1153_CR10","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.cjca.2018.02.022","volume":"34","author":"KA Nerenberg","year":"2018","unstructured":"Nerenberg KA, Zarnke KB, Leung AA, Dasgupta K, Butalia S, McBrien K, et al. Hypertension Canada\u2019s 2018 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults and children. Can J Cardiol. 2018;34:506\u201325.","journal-title":"Can J Cardiol"},{"key":"1153_CR11","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","volume":"71","author":"PK Whelton","year":"2018","unstructured":"Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and Management of High Blood Pressure in adults: a report of the American College of Cardiology\/American Heart Association task force on clinical Pr. J Am Coll Cardiol. 2018;71:e127\u2013248.","journal-title":"J Am Coll Cardiol"},{"key":"1153_CR12","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","volume":"36","author":"B Williams","year":"2018","unstructured":"Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC\/ESH guidelines for the management of arterial hypertension: the task force for the Management of Arterial Hypertension of the European Society of Cardiology and the European Society of Hypertension: the task force for the Management of Arterial Hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36:1953\u20132041.","journal-title":"J Hypertens"},{"key":"1153_CR13","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1111\/jch.13276","volume":"20","author":"MG Myers","year":"2018","unstructured":"Myers MG, Asmar R, Staessen JA. Office blood pressure measurement in the 21st century. J Clin Hypertens. 2018;20:1104\u20137.","journal-title":"J Clin Hypertens"},{"key":"1153_CR14","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1001\/jamainternmed.2018.6551","volume":"179","author":"M Roerecke","year":"2019","unstructured":"Roerecke M, Kaczorowski J, Myers MG. Comparing automated office blood pressure readings with other methods of blood pressure measurement for identifying patients with possible hypertension: a systematic review and meta-analysis. JAMA Intern Med. 2019;179:351\u201362.","journal-title":"JAMA Intern Med"},{"key":"1153_CR15","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1136\/heartjnl-2017-312523","volume":"104","author":"T Burkard","year":"2018","unstructured":"Burkard T, Mayr M, Winterhalder C, Leonardi L, Eckstein J, Vischer AS. Reliability of single office blood pressure measurements. Heart. 2018;104:1173\u20139.","journal-title":"Heart."},{"key":"1153_CR16","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1161\/HYPERTENSIONAHA.110.162123","volume":"57","author":"TJ Niiranen","year":"2011","unstructured":"Niiranen TJ, Johansson JK, Reunanen A, Jula AM. Optimal schedule for home blood pressure measurement based on prognostic data: the finn-home study. Hypertension. 2011;57:1081\u20136.","journal-title":"Hypertension"},{"key":"1153_CR17","doi-asserted-by":"publisher","first-page":"64","DOI":"10.12809\/hkmj195089","volume":"25","author":"MK Lim","year":"2019","unstructured":"Lim MK, Ha SCN, Luk KH, Yip WK, Tsang CSH, Wong MCS. Update on the Hong Kong reference framework for hypertension Care for Adults in primary care settings - review of evidence on the definition of high blood pressure and goal of therapy. Hong Kong Med J. 2019;25:64\u20137.","journal-title":"Hong Kong Med J"},{"key":"1153_CR18","first-page":"e193","volume":"63","author":"J Kaczorowski","year":"2017","unstructured":"Kaczorowski J, Myers MG, Gelfer M, Dawes M, Mang EJ, Berg A, et al. How do family physicians measure blood pressure in routine clinical practice? National survey of Canadian family physicians. Can Fam Physician. 2017;63:e193\u20139.","journal-title":"Can Fam Physician"},{"key":"1153_CR19","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1590\/S0066-782X2002001500005","volume":"79","author":"D Mion Jr","year":"2002","unstructured":"Mion D Jr, Pierin AMG, Lessa I, Nobre F. Devices and techniques for blood pressure measurement and criteria for hypertension adopted by Brazilian physicians: exploratory study. Arq Bras Cardiol. 2002;79:597\u2013600 593-6.","journal-title":"Arq Bras Cardiol"},{"key":"1153_CR20","doi-asserted-by":"publisher","first-page":"215","DOI":"10.3122\/jabfm.2013.02.120024","volume":"26","author":"RC Dickson","year":"2013","unstructured":"Dickson RC, Gaebel K, Zizzo A, Neimanis I, Bridge M, Corsini J, et al. Self-reported physician adherence to guidelines for measuring blood pressure. J Am Board Fam Med. 2013;26:215\u20137.","journal-title":"J Am Board Fam Med"},{"key":"1153_CR21","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1038\/hr.2010.89","volume":"33","author":"M Kobayashi","year":"2010","unstructured":"Kobayashi M, Obara T, Ohkubo T, Fukunaga H, Satoh M, Metoki H, et al. Practice and awareness of physicians regarding casual-clinic blood pressure measurement in Japan. Hypertens Res. 2010;33:960\u20134.","journal-title":"Hypertens Res"},{"key":"1153_CR22","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.cjca.2011.09.004","volume":"28","author":"MG Myers","year":"2012","unstructured":"Myers MG, Godwin M. Automated office blood pressure. Can J Cardiol. 2012;28:341\u20136.","journal-title":"Can J Cardiol"},{"key":"1153_CR23","first-page":"317","volume":"41","author":"F Howes","year":"2012","unstructured":"Howes F, Hansen E, Nelson M. Management of hypertension in general practice: a qualitative needs assessment of Australian GPs. Aust Fam Physician. 2012;41:317\u201323.","journal-title":"Aust Fam Physician"},{"key":"1153_CR24","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/j.jash.2017.06.012","volume":"11","author":"IM Kronish","year":"2017","unstructured":"Kronish IM, Kent S, Moise N, Shimbo D, Safford MM, Kynerd RE, et al. Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States. J Am Soc Hypertens. 2017;11:573\u201380.","journal-title":"J Am Soc Hypertens"},{"key":"1153_CR25","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020589","volume":"8","author":"SL Stevens","year":"2018","unstructured":"Stevens SL, McManus RJ, Stevens RJ. Current practice of usual clinic blood pressure measurement in people with and without diabetes: a survey and prospective \u2018mystery shopper\u2019 study in UK primary care. BMJ Open. 2018;8:e020589.","journal-title":"BMJ Open"},{"key":"1153_CR26","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s11906-019-0936-9","volume":"21","author":"RT Boonyasai","year":"2019","unstructured":"Boonyasai RT, McCannon EL, Landavaso JE. Automated office-based blood pressure measurement: an overview and guidance for implementation in primary care. Curr Hypertens Rep. 2019;21:29.","journal-title":"Curr Hypertens Rep"},{"key":"1153_CR27","doi-asserted-by":"publisher","first-page":"10302","DOI":"10.1038\/s41598-018-28721-2","volume":"8","author":"BHK Yip","year":"2018","unstructured":"Yip BHK, Lee EKP, Sit RWS, Wong C, Li X, Wong ELY, et al. Nurse-led hypertension management was well accepted and non-inferior to physician consultation in a Chinese population: a randomized controlled trial. Sci Rep. 2018;8:10302.","journal-title":"Sci Rep"}],"container-title":["BMC Family Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-020-01153-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-020-01153-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-020-01153-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T19:08:29Z","timestamp":1621969709000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcfampract.biomedcentral.com\/articles\/10.1186\/s12875-020-01153-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,26]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1153"],"URL":"https:\/\/doi.org\/10.1186\/s12875-020-01153-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.20342\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.20342\/v1","asserted-by":"object"}]},"ISSN":["1471-2296"],"issn-type":[{"value":"1471-2296","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,26]]},"assertion":[{"value":"20 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 April 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Chinese University of Hong Kong, Survey and Behavioural Research Ethics Committee (Ref no: SBRE-18-563.) and was registered in the clinical trial registry (\n                      \n                      ; ref. no.: NCT03926897). Implied Consent was obtained by the mailing back of questionnaire. This was explained on the front page of the questionnaire and approved by the aforementioned ethics committee.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"One of the co-authors, Samuel Yeung Shan Wong, is a member of the editorial board (Associate Editor) of this journal.All other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"95"}}