Blood pressure readings remain consistent in noisy and public settings

1. In this randomized crossover trial, differences in mean blood pressure readings between private and public settings were minimal.

2. Blood pressure measurements also did not differ significantly between loud and quiet public spaces.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Despite clinical guidelines for hypertension highlighting the importance of proper patient orientation for blood pressure (BP) measurement, BP screening is often done in loud spaces. Previous studies on BP have focused on comparing measurements taken in a home or community versus a physician’s office. However, none have focused on the effects of noise on BP readings. To address this gap in the literature, this randomized crossover trial aimed to determine the effects of noise and setting on screening BP, with a particular interest in patients with hypertension, older age, and recent health care utilization. Over one hundred adults were recruited for the study, and it was found that BP readings in a quiet, private setting were similar to those in a loud, public setting. These results were consistent in sensitivity analyses adjusting for use of antihypertensives, arm circumference, and treatment order. This study was conducted at a single center with a relatively small sample size, thus limiting the generalizability of the results. Nonetheless, the study’s findings challenged existing screening guidelines and suggested that convenient public spaces may be acceptable environments for measuring BP.

Click to read the study in AIM

Relevant Reading: Blood pressure measurement in public places

In-Depth [randomized controlled trial]: This randomized crossover trial was conducted to compare BP readings in different noise-level settings. Eligible participants were randomly assigned to one of three conditions: a private office, a loud public space, and the same loud public space but with patients wearing earplugs. The total number of participants in the study was 108 (mean age, 56.0 years [SD, 16.5]), of whom 74 (68.5%) took antihypertensive medication and 49 (45.4%) had an SBP of 130 mm Hg or higher. The mean noise levels of the private quiet office and the loud public space were 37 dB and 74 dB, respectively. The mean systolic BP (SBP) values were 128.9 and 128.3 mm Hg, and the mean diastolic BP (DBP) values were 74.2 and 75.9 mm Hg, respectively. For the public quiet setting, the mean SBP and DBP were 129.0 mm Hg and 75.7 mm Hg, respectively. The differences between the mean SBP and DBP in the loud public space and the private office were minimal and not clinically significant (ΔSBP = -0.66 mm Hg [95% CI, -2.25 to 0.93 mm Hg], P = 0.41; and ΔDBP = 1.65 mm Hg [CI, 0.77 to 2.54 mm Hg], P = <0.001). Similarly, the differences between the public quiet and private quiet mean SBPs and DBPs were minimal (ΔSBP = 0.09 mm Hg [CI, -1.53 to 1.72 mm Hg], P = 0.91; and ΔDBP = 1.45 mm Hg [CI, 0.64 to 2.27 mm Hg], P = <0.001).

Image: PD

©2025 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.