Effects of Smartphone Use and Television Viewing on Standardized BP Measurement: The SCREENS-BP Study

Accurate blood pressure (BP) measurement is essential for the diagnosis and management of hypertension. Current guidelines recommend standardized measurement conditions, including a period of rest and the avoidance of distractions. However, these conditions may not reflect routine clinical practice or home BP monitoring, where activities such as smartphone use or television viewing are common. The clinical impact of these technological distractions on BP measurements remains uncertain. SCREENS-BP is a randomized crossover study designed to evaluate whether smartphone use and television viewing influence BP measurements obtained under otherwise standardized conditions. The study will recruit 96 adults aged 18 years or older. Each participant will complete four sets of BP measurements on the non-dominant arm using a validated automated oscillometric device. Each set will include a five-minute rest period followed by three BP measurements taken at one-minute intervals, without staff present in the room. Before each set, participants will walk slowly for two minutes and then be positioned according to standardized BP measurement recommendations. The first three measurement conditions will be performed in randomized order: 1. Standardized BP measurement without distractions. 2. BP measurement while actively using a smartphone. 3. BP measurement while watching a standardized informational video on a television. A fourth set of standardized BP measurements without distractions will be performed at the end of the protocol to account for within-participant BP variability and potential changes in BP over time. The primary outcome will be the within-participant difference in mean systolic BP between each distraction condition and the reference BP, calculated as the average of the two standardized measurement sets. Secondary outcomes will include differences in diastolic BP and heart rate. Exploratory analyses will evaluate potential effect modification by sex, age, baseline BP, and antihypertensive medication use, as well as the robustness of the results across different statistical approaches. By quantifying the impact of common technological distractions on BP measurements, SCREENS-BP aims to inform recommendations for BP measurement in clinical settings, at home, in pharmacies, and in research. The results may support stricter standardization of measurement conditions or provide evidence for more flexible protocols if no clinically meaningful differences are observed.