Is it Really High Blood Pressure?
More than half of family doctors in Canada are still using manual devices, a dated technology that often leads to misdiagnosis.
A study by researchers at the University of Montreal Hospital Research Centre (CRCHUM) reports that over half of the Canadian family doctors are still making use of manual devices to measure blood pressure, which is a dated technology. Using a manual device to measure blood pressure often leads to misdiagnosis. Approximately 20% of those receiving treatment for hypertension don't actually have it and do not need medication.
Automatic electronic devices, called oscillometric devices, are available and are recommended by the Guidelines of the Canadian Hypertension Education Program (CHEP) as preferable to manual measurement.
However, in the spring of 2016, the team that conducted the survey among the Canadian family doctors found that 52% of the 769 who responded stated that they made use of a manual tensiometer to measure patients' blood pressure, and only 43% used an automatic device.
The lead author of the study, Janusz Kaczorowski, is a medical sociologist, a CRCHUM researcher, and a professor in the Department of Family and Emergency Medicine.
Manual measurement is acceptable if it is done properly, but that is not always the case. Kaczorowski stated that clinicians should use automatic devices because they are more precise and take several measurements. Automated measurement has an advantage because it eliminates “white-coat syndrome,” which is an artificially high blood pressure reading that is a result of being in a doctor's office.
To take blood pressure properly, a 12- to 15-minute period is required with the patient being left alone in a room while the measurement is taken. That is difficult because the average visit to a family doctor lasts only 10 minutes.
Blood pressure is the pressure that the blood exerts on the walls of arteries. Measured in an artery in the arm, blood pressure has two measurements: systolic as the heart contracts and diastolic as the heart relaxes. Normal pressure has the systolic pressure at below 140 mmHg and the diastolic pressure at below 90 mmHg. Above those numbers, a person is said to have high blood pressure or hypertension.
In Canada, one of every five adults suffers from hypertension, which is the greatest global risk factor for disability and death. Healthcare costs due to hypertension were evaluated at over $13 billion in 2010. Kaczorowski says that if blood pressure was measured incorrectly, there are considerable financial implications as well as possible side effects, which could be avoided.
The CHEP Guidelines state that modification of health-related behaviors is an efficient way of treating and preventing high blood pressure and reducing the cardiovascular disease risk. It is possible to lower one's blood pressure with a healthy diet, reduced intake of sodium, regular physical activity, moderate consumption of alcohol, tobacco product avoidance, and stress management.
How do family physicians measure blood pressure in routine clinical practice? A national survey of Canadian family physicians was published on March 14, 2017 in Canadian Family Physician. To find out more, the study is available at: http://www.cfp.ca/content/63/3/e193.full.pdf+html Source: University of Montreal Hospital Research Centre (CRCHUM)