Blood Pressure

Blood pressure (section: physical state) was measured in all Lifelines participants aged 8 years and older during:

• 1A Visit 1 (n = ~163.000, including ~11.000 children)
• 2A Visit 1 (n = ~119.000)
• 3A Visit 1 (n = ~81.000)
• 4A Visit 1 (ongoing)

Blood pressure was measured with the participant seated. The size of the cuff was chosen according to the arm circumference of the participant.

As of Assessment 4A, from February 2025, blood pressure was only measured in participants who did not or could not complete the Blood Pressure Self-measurement.

At 1A and 2A, blood pressure was measured automatically using the DinaMap PRO100 or DinaMap PRO100V2 critikon-dinamap-pro-op-manual.pdf.

At 3A and 4A, blood pressure was measured automatically using the ABPM 7100.

Blood pressure was not taken in case of:

• Lymph node surgery on the right breast or armpit
• Complaints of fluid accumulation in the right arm
• No blood pressure measurement on the side of a dialysis shunt

• Participant is seated and informed about the procedure. Participant is requested to sit still, to keep quiet, and to not move the arm.
• Research nurse informs about contraindications: recent axillary lymph node dissection; dialysis arterial-venous shunt; complaints of quick fluid retention/edema in the arm.
• If none are present, measurement is taken at the bare upper right arm. If any are present (in the right arm) the blood pressure measurement is taken at the left upper arm. This registered by the research nurse.
• The cuff, standard size M, is placed on the bare upper arm. For proper fit of the cuff check if the end of the cuff falls within the two indicated lines. If this is not the case use a smaller (S) or a larger (L or XL) cuff to avoid errors.
• The arrow on the cuff is placed over the branchial artery, 2.5 cm above the elbow crease. It should fit snugly without being too tight.
• Dinamap/ABPM is connected to a PC and recordings are processed automatically, the research nurse checks if readings are complete and additionally takes notes of the measurements.
• In total 10 (1A Visit 1), or 3 (2A visit 1, 3A visit 1, 4A visit 1) measurements are taken. At 2A, 3A, and 4A a small amount of participants received more measurements, which results in more than 3 available variables.
• Cuff is removed. And if requested by participant, the last recording is given.

For assessment 1A, the average systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated according to the following protocol. The calculation method per participant can be found in variable 'bpavg_calculation_all_m_v1'

For assessment 2A, 3A, and 4A, the average systolic and diastolic blood pressures were calculated using the second and third successful measurement. If the second and/or third measurement was not successful, the last successful measurement (out of a maximum of six) was used as the average value (note that occurred in very few cases). The calculation method per participant can be found in variable 'bpavg_calculation_all_m_v2'

The following variables were measured: