Quality control of the blood pressure phenotype in the European Project on Genes in Hypertension.
OBJECTIVE
In the European Project on Genes in Hypertension (EPOGH) standardized epidemiological methods were used to determine complex phenotypes consisting of blood pressure (BP) in combination with other traits. In this report, we present the quality control of one of the BP phenotypes.


METHODS
In seven European countries eight different research groups recruited random samples of nuclear families. Trained observers measured the BP five times consecutively with the participants in the seated position at each of two separate home visits, 1 to 3 weeks apart, according to the guidelines of the British Hypertension Society. Quality assurance and quality control of this BP phenotype were implemented according to detailed instructions defined in the protocol of the EPOGH study.


RESULTS
On 31 August 2001, BP measurements of 2476 subjects were available for analysis. Fewer BP readings than the five planned per visit occurred in one of the eight centres, but only in 0.4% of the home visits. Across centres the relative frequency of identical consecutive readings for systolic or diastolic blood pressure varied from 0 to 6%. The occurrence of odd readings ranged from 0 to 0.1%. Of the 49,488 systolic and diastolic BP readings, 24.0% ended on a zero (expected 20%). In most EPOGH centres there was a progressive decline in the BP from the first to the second home visit. Overall, these decreases averaged 2.36 mmHg [95% confidence interval (CI): 1.98-2.74, P < 0.001] for systolic BP and 1.74 mmHg (95% CI: 1.46-2.02, P < 0.001) for diastolic BP.


CONCLUSIONS
Quality assurance and control should be planned at the design stage of a project involving BP measurement and implemented from its very beginnings until the end. The procedures of quality assurance set up in the EPOGH study for the BP measurements resulted in a well-defined BP phenotype, which was consistent across centres.
Study Coordinating Centre, Hypertension and Cardiovascular Rehabilitation Unit, Department of Molecular and Cardiovascular Research, University of Leuven, Leuven, Belgium. tatiana.kouznetsova@student.kuleuven.ac.be
Tatiana
T
Kuznetsova
Jan A
JA
Staessen
Kalina
K
Kawecka-Jaszcz
Speranta
S
Babeanu
Edoardo
E
Casiglia
Jan
J
Filipovsky
Choudomir
C
Nachev
Yuri
Y
Nikitin
Jan
J
Peleskã
Eoin
E
O'Brien
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000592:standards*; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010641:Phenotype; D011785:Quality Assurance, Health Care; D011786:Quality Control; D011897:Random Allocation; D012494:Sampling Studies