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Who's Taking Your Blood Pressure -- Seriously?So I'm going to the doctor's for a routine visit. I'm a bit late and had to park a block or so away, I practically run the distance to the office. I check in at the front desk, turn to take my place behind a 1999 copy of Sunset magazine, when the doctor's assistant calls my name. She leads me into a small room and takes my blood pressure (BP). She gets a reading of 196 over 95. " A bit high", she says. A bit high? I had taken it at home only an hour ago with a reading of 119 over 72: I'll say it's a bit high. During an insurance exam only a month ago, the nurse took a reading of 121 over 70. A bit high?I mentioned the high BP reading to the doctor when he came in. " Oh that thing," pointing to a little electronic device, "everybody tells us it reads high. Just forget about it and use your home reading..." Uh huh. I'm a bit confused. Haven't we all been inundated with public service announcements about high blood pressure (hypertension) for many, many years? "Have your blood pressure checked regularly," the radio announcer would say. High blood pressure is indeed dangerous. According to the American Heart Association, about 65 million Americans have hypertension. From 1992 to 2002, the death rate from high blood pressure increased by 26.8 percent, and the actual number of deaths rose by 56.6 per cent. Now, thanks to recently revised high blood pressure classifications, one study from the University of Illinois says that maybe 60% of all American adults may have high blood pressure. Yikes! Hypertension is associated with increased risk of heart failure, stroke, heart attack, kidney failure and liver problems. There is no question that keeping an eye on blood pressure should be an important part of any healthy life style. Yet, who would have thought that performing a seemingly simple blood pressure test, could be so fraught with potential mistakes and even lead to misdiagnosis and improper treatment? Three things have an effect on your blood pressure reading. The patient, the test administrator, and the equipment. Some people simply get nervous whenever they go to the doctor's office, this phenomena is sometimes called 'white coat syndrome.' Other factors that the patient brings to the test might include whether or not the patient was exercising, or maybe 'ran up the stairs' to make the appointment on time. Drinking, coffee, and taking certain medications just prior to the test may affect results. As for the test administrator, try to remember the last time you had your blood pressure taken. Did the nurse: * Ask if you were on medication, had been exercising in the last hour or two. Ask if you had been smoking or drinking caffeine prior to the test? * Did the nurse have you wait quietly in a chair for several minutes before starting the test? * Did the nurse check for proper positioning of the cuff (check for a pulse)? * If you are a larger person, or smaller person, did they use the appropriate size cuff. * Did they raise your arm and support it 'above' your heart while taking the measurement? * If your result was unusually high or low, did they repeat the test, waiting at least two minutes. Any deviation from the list above could result in an inaccurate reading. Now think about the consequences. With an artificially high reading, you'll be going home thinking you have high blood pressure when in fact, you may not, and conversely, with an inaccurate low reading, you'll be going home thinking you don't have it, when you may. One other factor that can give the wrong result is a poorly calibrated instrument. Blood pressure is taken with a sphygmomanometer (BP cuff) . There are three different types, mercury, aneroid and digital. All three have advantages and disadvantages. The mercury sphygmomanometer, is the most accurate, but all three require routine calibration. The real question is; does that ever happen? Ask your doctor when was the last time his or her BP cuff was checked for accuracy. The American heart Association recommends BP equipment be checked at least every year. What about checking your blood pressure at home? Not a bad idea. A recent report printed in the March 17th issue of the American Medical Association, says "Home blood pressure monitoring may have better prognostic accuracy than office blood pressure measurements for patients treated for high blood pressure."
Hypertension is a real killer. Keeping tabs on your own blood pressure only makes sense. Whether you do it at the doctor's office, the drug store, or at home, learn more about how its done, and what is required to obtain an accurate result. Blood pressure testing may not be rocket science, but it IS science, and the patient and the medical professional should regard the test as seriously as the disease itself. Gary Bryant, a consumer health advocate, is the executive producer of the award winning web resource, BreakThroughDigest.com. He is also the author of Searching The Web for Health, A Guide to Reliable Medical Informat Recommended Product :
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