Impact of Single-Occasion American vs. Canadian Office Blood Pressure Measurement Recommendations on Blood Pressure Classification
Bibliographic record
Abstract
BACKGROUND: The 2017 American hypertension guidelines [American College of Cardiology/American Heart Association (ACC/AHA)] define a blood pressure measurement (BPM) procedure that differs from the Canadian Hypertension Education Program (CHEP) guidelines. We studied the impact of the BPM procedure on arterial hypertension (AHT) prevalence rate. METHODS: In 805 subjects, the mean of the first and second BPM (adapted ACC/AHA procedure) was compared with the mean of the second and third BPM (CHEP procedure). All BPMs were taken at a single occasion. According to ACC/AHA definition, office blood pressure (OBP) of <120/80 mm Hg was classified as normal, 120-129/<80 mm Hg as elevated, and ≥130/80 mm Hg as hypertensive. RESULTS: Using the adapted ACC/AHA BPM procedure compared to the CHEP BPM procedure led to an increase in the AHT prevalence rate (≥130/80 mm Hg) of 4% (58% vs. 54%). Overall, 8.9% (72/805) of subjects were reclassified to a higher and 2.6% (21/805) to a lower blood pressure category when using the adapted ACC/AHA BPM procedure instead of the CHEP BPM procedure. In the group with elevated OBP (120-129/<80 mm Hg), 41.9% (36/86) of subjects were reclassified. CONCLUSIONS: Minimal changes of BPM procedures lead to relevant changes of hypertension prevalence. CLINICAL TRIALS REGISTRATION: Trial Number NCT02552030.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.052 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".