Best Rest: Rest Time Before Blood Pressure Measurement Trial

Study Overview
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Brief Summary
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The objectives of this study are to: Determine the impact of wait time before initiating BP measurement on BP variability Determine the difference in BP variability between measurements by amount of initial rest. The investigators also aim to: 1. To determine the total time required to obtain a BP measurement.

Detailed Description
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Hypertension guidelines recommend a minimum of five minute rest time prior to blood pressure (BP) measurements obtained for screening, diagnosis and management of hypertension. This recommended wait time is often not adhered to and is cited as a barrier to regular screening due to length of time, clinic workflow and provider burden. It is unclear if BPs obtained at different rest intervals would provide clinically similar measurements. This study therefore aims to determine if BPs obtained immediately or after 2 minutes are rest are non-inferior to the BPs obtained after the guideline recommended 5 minutes of rest. It also aims to determine the time required to measure BP from start to finish, to allow for easier identification of other potential barriers to regular BP screening practices in busy clinical settings.

Official Title
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Rest Time Before Blood Pressure Measurement Trial

Conditions
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Hypertension, Blood Pressure, Cardiovascular Diseases, Cardiovascular Risk Factor

Intervention / Treatment
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* Other: Timing of rest prior to blood pressure measurement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-80 years Exclusion Criteria: Presence of the following on both arms: rashes, gauze dressings, casts, edema, paralysis, tubes, open sores or wounds, withered arms, A-V shunts, or if blood has been drawn from arm within last week. Being mentally impaired, pregnant. Arm circumference exceeding 50 cm.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: 0-2-5-5 minutes rest group<br>The order of rest periods for participants randomized to this arm will be: 0 minutes 2 minutes 5 minutes 5 minutes | Other: Timing of rest prior to blood pressure measurement<br>* Each participant will have 4 sets of 3 blood pressure measurements taken. The participants will be randomized to the order in which they rest prior to each set of measurements.<br>|
| Other: 0-5-2-5 minutes rest group<br>The order of rest periods for participants randomized to this arm will be: 0 minutes 5 minutes 2 minutes 5 minutes | Other: Timing of rest prior to blood pressure measurement<br>* Each participant will have 4 sets of 3 blood pressure measurements taken. The participants will be randomized to the order in which they rest prior to each set of measurements.<br>|
| Other: 2-0-5-5 minutes rest group<br>The order of rest periods for participants randomized to this arm will be: 2 minutes 0 minutes 5 minutes 5 minutes | Other: Timing of rest prior to blood pressure measurement<br>* Each participant will have 4 sets of 3 blood pressure measurements taken. The participants will be randomized to the order in which they rest prior to each set of measurements.<br>|
| Other: 5-0-2-5 minutes rest group<br>The order of rest periods for participants randomized to this arm will be: 5 minutes 0 minutes 2 minutes 5 minutes | Other: Timing of rest prior to blood pressure measurement<br>* Each participant will have 4 sets of 3 blood pressure measurements taken. The participants will be randomized to the order in which they rest prior to each set of measurements.<br>|
| Other: 2-5-0-5 minutes rest group<br>The order of rest periods for participants randomized to this arm will be: 2 minutes 5 minutes 0 minutes 5 minutes | Other: Timing of rest prior to blood pressure measurement<br>* Each participant will have 4 sets of 3 blood pressure measurements taken. The participants will be randomized to the order in which they rest prior to each set of measurements.<br>|
| Other: 5-2-0-5 minutes rest group<br>The order of rest periods for participants randomized to this arm will be: 5 minutes 2 minutes 0 minutes 5 minutes | Other: Timing of rest prior to blood pressure measurement<br>* Each participant will have 4 sets of 3 blood pressure measurements taken. The participants will be randomized to the order in which they rest prior to each set of measurements.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference in Systolic Blood Pressure (mmHg) | Comparison of the average of 3 systolic BP measurements (mmHg) measured after 5 minutes rest with the average of 3 systolic blood pressure (SBP) measured after the other periods of rest (0 minutes, 2 minutes, second 5 minutes of rest) | 90 minutes | 
| Difference in Diastolic Blood Pressure (mmHg) | Comparison of the average of 3 diastolic BP measurements (mmHg) measured after 5 minutes rest with the average of 3 diastolic blood pressure (DBP) measured after the other periods of rest (0 minutes, 2 minutes, second 5 minutes of rest) | 90 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood Pressure Variability (mmHg) | Difference between individual systolic and diastolic BP measurements (BP reading 1 - BP reading 2; BP reading 2 - BP reading 3) obtained per each rest period | 90 minutes | 
| Standard Deviation of Blood Pressures (mmHg) | Difference in standard deviation of the mean of 3 systolic and diastolic BPs obtained at each rest period | 90 minutes | 
| Coefficient of Variation of Blood Pressures | Difference in coefficient of variation (SD/mean) of 3 systolic and diastolic BPs obtained at each rest period | 90 minutes |