A13500 Do physicians measure patients’ blood pressure, and are those measurements reliable?

Abstract

Objectives: To determine how and how often blood pressure (BP) measurement is performed in health institutions. Methods: The researchers observed whether or not 84 physicians performed BP measurement and physicians complied with contemporary hypertension (HT) guideline recommendations during BP measurement. Immediately after BP measurement by the physician, this was repeated by the researchers in a manner compatible with HT guidelines. The physicians’ and researchers’ BP measurement results were compared. Results: Physicians measured BP in only 37% (427) of 1130 consecutive patient examinations. None of the physicians ‘ BP measurements were fully compatible with the guidelines’ BP measurement recommendations. The most common errors were patients resting for less than 5 min before BP measurement (47.1%), failure to note room temperature and whether or not the patient's bladder is empty (100%), failure to use a cuff size appropriate for the forearm circumference (57.8%), rounding up at the end of BP measurement (92%), failure to support the forearm (64.2%) and back (81.3%). Physicians who performed measurements determined the same SBP and DBP as the researchers in 34.3% of patients (Figure 1, 2). Hypertension was determined in 18.9% of patients in clinics in which BP measurement was not performed by physicians. Conclusion: Not all physicians in our study measured BP, and the great majority of those who did failed to measure it reliably. We think that it is therefore vitally important for physicians across the world to receive regular, repeated and effective training in the importance of BP measurement and how to perform it correctly.