Assessment of blood pressure measuring techniques

McKay, Donald W.; Raju, M. K.; Campbell, N. R. C.

doi:10.1111/j.1365-2923.1992.tb00155.x

Cited by 32 publications

(13 citation statements)

References 6 publications

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“…What is more worrying, while in the same time at least partially explaining why such huge discrepancies may occur in practice, is the fact that gaps in the basic theoretic and practical knowledge seem to be common among interns and first-year family practice residents, supposed to have just acquired the skills for accurate blood pressure measurement [29]. An interesting observational study in this respect, carried out at the Westminster Medical School in London, showed that 33% out of 80 doctors in training grades/junior hospital doctors, acknowledged no formal education on how to measure blood pressure, a finding confirmed further by the poor accuracy in blood pressure measurement displayed by one third of the study group [30].…”

Section: Introduction and Magnitude Of The Background Problemmentioning

confidence: 99%

Beyond the Evidence of the New Hypertension Guidelines. Blood pressure measurement – is it good enough for accurate diagnosis of hypertension? Time might be in, for a paradigm shift (I)

Pater

2005

Trials

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Despite widespread availability of a large body of evidence in the area of hypertension, the translation of that evidence into viable recommendations aimed at improving the quality of health care is very difficult, sometimes to the point of questionable acceptability and overall credibility of the guidelines advocating those recommendations.The scientific community world-wide and especially professionals interested in the topic of hypertension are witnessing currently an unprecedented debate over the issue of appropriateness of using different drugs/drug classes for the treatment of hypertension. An endless supply of recent and less recent "drug-news", some in support of, others against the current guidelines, justifying the use of selected types of drug treatment or criticising other, are coming out in the scientific literature on an almost weekly basis. The latest of such debate (at the time of writing this paper) pertains the safety profile of ARBs vs ACE inhibitors.To great extent, the factual situation has been fuelled by the new hypertension guidelines (different for USA, Europe, New Zeeland and UK) through, apparently small inconsistencies and conflicting messages, that might have generated substantial and perpetuating confusion among both prescribing physicians and their patients, regardless of their country of origin.The overwhelming message conveyed by most guidelines and opinion leaders is the widespread use of diuretics as first-line agents in all patients with blood pressure above a certain cut-off level and the increasingly aggressive approach towards diagnosis and treatment of hypertension. This, apparently well-justified, logical and easily comprehensible message is unfortunately miss-obeyed by most physicians, on both parts of the Atlantic. Amazingly, the message assumes a universal simplicity of both diagnosis and treatment of hypertension, while ignoring several hypertension-specific variables, commonly known to have high level of complexity, such as: -accuracy of recorded blood pressure and the great inter-observer variability, -diversity in the competency and training of diagnosing physician, -individual patient/disease profile with highly subjective preferences, -difficulty in reaching consensus among opinion leaders,

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Section: Introduction and Magnitude Of The Background Problemmentioning

confidence: 99%

Beyond the Evidence of the New Hypertension Guidelines. Blood pressure measurement – is it good enough for accurate diagnosis of hypertension? Time might be in, for a paradigm shift (I)

Pater

2005

Trials

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“…4 Observation of other health professions' literature suggests that measurement techniques may be out of line with current recommendations in various health care fields. [4][5][6][7][8][9] For example, one study showed that many physicians did not have the patient rest at least 5 minutes before the blood pressure measurement, 5 and another showed that few physicians, if any, followed the American Heart Association guidelines when measuring blood pressure. 6,7 A final report showed that physicians used improper cuff sizes.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7][8][9] For example, one study showed that many physicians did not have the patient rest at least 5 minutes before the blood pressure measurement, 5 and another showed that few physicians, if any, followed the American Heart Association guidelines when measuring blood pressure. 6,7 A final report showed that physicians used improper cuff sizes. 8 Although to our knowledge there have been no studies of the blood pressure assessment skills of chiropractic students, we have postulated that the skills of chiropractic students would be no different from those of other health care professionals.…”

Section: Introductionmentioning

confidence: 99%

Knowledge of accurate blood pressure measurement procedures in chiropractic students

Crosley¹,

Rose²

2013

Journal of Chiropractic Education

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Objective: Blood pressure measurement is a basic clinical procedure. However, studies have shown that many errors are made when health care providers acquire blood pressure readings. Our study assessed knowledge of blood pressure measurement procedures in chiropractic students. Methods: This was an observational, descriptive study. A questionnaire based on one created by the American Heart Association was given to 1st, 2nd, 3rd, and final year students (n ¼ 186). A one way ANOVA was used to analyze the data. Results: Of the students 80% were confident that their knowledge of this clinical skill was adequate or better. However, the overall score on the knowledge test of blood pressure-taking skills was 52% (range, 24%-88%). The only significant difference in the mean scores was between the 1st and 2nd year students compared to the 3rd and 4th year students (p , .005). Of the 16 questions given, the following mean scores were: 1st year 10.45, 2nd year 9.75, 3rd year 7.93, and 4th year 8.33. Of the 16 areas tested, 10 were of major concern (test item score ,70%), showing the need for frequent retraining of chiropractic students. Conclusion: Consistent with studies in other health care disciplines, our research found the knowledge of blood pressure skills to be deficient in our sample. There is a need for subsequent training in our teaching program.

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“…[8] The wide gaps in the basic theoretic and practical knowledge seem to be common among interns and first-year family practice residents resulting in erroneous measurements. [9] In an interesting obser vational study, carr ied out at the Westminster Medical School in London, showed that 33% out of 80 doctors in training grades/junior hospital doctors, acknowledged no formal education on how to measure BP, a finding confir med fur ther by the poor accuracy in BP measurement displayed by one-third of the study group. [10] …”

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confidence: 99%

Accurate blood pressure recording: Is it difficult?

Bhalla¹,

Singh²,

D’cruz³

et al. 2005

Indian J Med Sci

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BACKGROUND: Blood pressure (BP) measurement is a routine procedure but errors are frequently committed during BP recording. AIMS AND SETTINGS: The aim of the study was to look at the prevalent practices in the institute regarding BP recording. The study was conducted in the Medicine Department at Government Medical College, Chandigarh, a teaching institute for MBBS students. METHODS: A prospective, observational study was performed amongst the 80 doctors in a tertiary care hospital. All of them were observed by a single observer during the act of BP recording. The observer was well versed with the guidelines issued by British Hypertension Society (BHS) and the deviations from the standard set of guidelines issued by BHS were noted. The errors were defined as deviations from these guidelines. STATISTICAL METHODS: The results were recorded as percentage of doctors committing these errors. RESULTS: In our study, 90% used mercury type sphygmomanometer. Zero error of the apparatus, hand dominance was not noted by any one. Every one used the standard BP cuff for recording BP. 70% of them did not let the patient rest before recording BP. 80% did not remove the clothing from the arm. None of them recorded BP in both arms. In out patient setting, 80% recorded blood pressure in sitting position and 14% in supine position. In all the patients where BP was recorded in sitting position BP apparatus was below the level of heart and 20% did not have their arm supported. 60% did not use palpatory method for noticing systolic BP and 70% did not raise pressure 30-40 mm Hg above the systolic level before checking the BP by auscultation. 80% lowered the BP at a rate of more than 2 mm/s and 60% rounded off the BP to nearest 5-10 mm Hg. 70% recorded BP only once and 90% of the rest re inflated the cuff without completely deflating and allowing rest before a second reading was obtained. CONCLUSION: The practice of recording BP in our hospital varies from the standard guidelines issued by the BHS.

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Assessment of blood pressure measuring techniques

Cited by 32 publications

References 6 publications

Beyond the Evidence of the New Hypertension Guidelines. Blood pressure measurement – is it good enough for accurate diagnosis of hypertension? Time might be in, for a paradigm shift (I)

Beyond the Evidence of the New Hypertension Guidelines. Blood pressure measurement – is it good enough for accurate diagnosis of hypertension? Time might be in, for a paradigm shift (I)

Knowledge of accurate blood pressure measurement procedures in chiropractic students

Accurate blood pressure recording: Is it difficult?

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