Measurement of blood pressure in European Society of Hypertension Excellence Centres: a survey by the Young Investigators Group of the European Society of Hypertension.

Automated electronic devices were the dominant method for office blood pressure measurement across ESH Excellence Centres.

• Automated electronic devices were used routinely in almost all outpatient facilities (96.7%)
• Manual auscultatory devices were used in 33.3% of healthcare facilities
• Among manual auscultatory devices, aneroid devices were used by the majority of participants (73.6%)
• Mercury sphygmomanometers were still used by 28.8% of respondents

Blood pressure was measured in multiple body positions across centres, with seated position being most common but non-seated positions also frequently used.

• BP was measured in seated position by 91.7% of respondents
• Standing position was used by 43.8% of respondents
• Supine position was used by 32.3% of respondents

Most ESH Excellence Centres performed multiple BP measurements per outpatient visit, with three measurements being the most common practice.

• 68.8% of respondents performed three BP measurements per outpatient
• 22.9% of respondents performed two BP measurements per outpatient
• This indicates variation in adherence to standardized measurement protocols

Home blood pressure monitoring was nearly universally advised by respondents at ESH Excellence Centres.

• 98.9% of respondents routinely advised home BP monitoring
• Those advising home BP monitoring provided precise instructions on how to perform the required measurements
• This represents one of the most consistently guideline-adherent practices identified in the survey

The survey achieved a response rate of 44% from a broad international sample of ESH Excellence Centres.

• The survey was sent to 216 recipients and 96 responses were collected
• Response rate was 44%
• Responses came from 29 different countries
• The survey comprised 17 items and was conducted over 8 weeks from December 2024 to February 2025
• The survey was distributed via email by the Young Investigators Group of the European Society of Hypertension (YIG-ESH)

Inaccurate blood pressure measurement practices can lead to significant misclassification and unnecessary treatment.

• Inaccurate BP readings can lead to significant misclassification, often overestimating BP
• Overestimation of BP can prompt unnecessary lifelong treatment
• Office BP measurement is described as 'the cornerstone of hypertension diagnosis and risk stratification'