SPOTLIGHT: Doctors and nurses rarely follow the rules when collecting important info about our health.

BIG PICTURE: During medical checkups, physicians once took blood pressure readings primarily to rule out dramatically high or dramatically low numbers. In that context, a lackadaisical approach maybe didn’t matter.

But we live in an era in which the definition of healthy blood pressure keeps being tightened. Mistaken readings can lead to unnecessary medications – and to potential side effects such as nausea, dizziness, lethargy, and impotence. Accuracy has become vital. But accuracy has never been a hallmark of these readings.

After 160 first-year medical students reported that they’d been trained in how to measure blood pressure, examiners discovered 90% didn’t know how to select the right cuff size, and that only two could pass a written test. When the six essential steps required for accurate readings were explained to them, none of 450 medical students reported that all those steps had been followed the last time their own blood pressure had been taken.

The American Heart Association says proper procedures are rarely followed, that some brands of devices have never been certified, and that others may provide inaccurate readings for ‘substantial numbers’ of patients.

When more than 500 devices in hospitals and private medical offices were inspected, most were found to be inaccurate or unreliable. Another study, involving nearly 500 devices at a large teaching hospital, concluded that more than half had ‘serious problems.’

Even when medical personnel follow the rules, our blood pressure varies throughout the day and can be skewed by many factors, including room temperature, recent exercise, alcohol consumption, or anxiety associated with a medical checkup.

TOP TAKEAWAY: Barring extreme cases, prescriptions for blood pressure medication should only be issued if multiple readings are taken, proper procedures are followed, and equipment receives regular maintenance.

LINKS:

• American Heart Association Scientific Statement, Recommendations for Blood Pressure Measurement in Humans and Experimental Animals, 2005
• the medical students study: part 1 & part 2
• in this study, one third of doctors admitted they’d received no formal training on how to take these readings
• this study found that a mispositioned arm during a blood pressure reading undermines accuracy
• the inaccurate and unreliable devices study
• more than half of devices in a teaching hospital had serious problems

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