title: Resting blood pressure and heart rate measurement in the Canadian Health Measures Survey, cycle 1.
abstract: BACKGROUND
  Directly measured blood pressure (BP) data have not been collected in Canada since the Canadian Heart Health Surveys, conducted between 1985 and 1992. Because hypertension is often asymptomatic, a large proportion of those with the condition are unaware of it.
  
  
  METHODS
  These analyses use BP and heart rate (HR) data from cycle 1 of the 2007-2009 Canadian Health Measures Survey (CHMS) for respondents aged 6 to 79 years. Methods and quality assurance and control procedures are explained. Logistical and feasibility issues that arose during data collection are discussed. The reasons for repeating a series of measures are given. Between- and within- series variations and inter-tester variability are assessed.
  
  
  RESULTS
  The BP and HR of almost all respondents who attended the examination centre were measured. Only one series of measurements was taken for 88% of respondents. The series was repeated for around 5% with variability in their BP or HR measurements. About 3% had HR or BP values above the screening cut-offs for the fitness tests. Almost 35% of respondents with HR or BP values above the screening cut-offs after their first series had values below the cut-points after the second series; a further 3% had values below after the third series. Within a series of six measurements, BP decreased until about the fourth measure, after which it remained stable. Mean BP and HR values indicated no inter-tester variability.
  
  
  CONCLUSIONS
  The protocol for measuring BP and HR by oscillometry in the CHMS appears to have produced reliable estimates. No benefit to repeating the series of six measurements a third time for screening purposes is evident. Four measurements may be sufficient to provide reliable BP and HR data. Oscillometry appears to eliminate inter-tester variability.
authors.affiliation: Physical Health Measures Division, Statistics Canada, Ottawa, Ontario K1A 0T6. Shirley.Bryan@statcan.gc.ca
authors.forename: Shirley
authors.initials: S
authors.lastname: Bryan
authors.forename: Mathieu
authors.initials: M
authors.lastname: Saint-Pierre Larose
authors.forename: Norm
authors.initials: N
authors.lastname: Campbell
authors.forename: Janine
authors.initials: J
authors.lastname: Clarke
authors.forename: Mark S
authors.initials: MS
authors.lastname: Tremblay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000592:standards*; D002170:Canada; D002648:Child; D016001:Confidence Intervals; D003971:Diastole; D005240:Feasibility Studies; D005260:Female; D006306:Health Surveys; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000592:standards; D015203:Reproducibility of Results; D012146:Rest / Q000502:physiology*; D011795:Surveys and Questionnaires; D013599:Systole; D055815:Young Adult