Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level: the Hygia Project

Abstract

We reviewed the 25 leading stories shown with a Google search for newspaper, TV and health information sites regarding JNC 8 to determine if the illustrations used met the standards for accurate BP measurement. We also reviewed the first 100 ‘‘images’’ flagged by a Google search for BP measurement. To be included it was necessary for the image to be able to be interpreted for the items mentioned above. Two reviewers reviewed the images independently. Of the 25 stories reviewed only 5/25 showed correct patient positioning, arm positioning was correct in only 2 of 25, the bell was not used in any, and the stethoscope head was placed correctly in onlyh 2/25. In general these depictions show BP being done in a manner that will tend to overestimate the true BP reading. Of the 100 images found with a Google search only 1 illustrated BP being done correctly. We urge those who report on BP issues review and use images that show BP being done correctly. Depicting BP being done wrong may reinforce poor technique for professionals and lead patients to assume that their BP measurements are accurate as they were taken as shown in the news. This will lead to over or under diagnosis of HTN as well as over or under treatment of BP to get to goal.