In the April issue of the American Journal of Hypertension, two doctors from the Mayo Clinic argue that doctors should stop measuring blood pressure of their patients themselves. Instead, BP measurements should be made by well-trained nurses or by validated BP-measuring devices. Why do they make this arguments? Because doctors just don't do it the right way, and as a result patients are treated inappropriately.
The authors (Drs. John W. Graves and Sheldon G. Sheps) point out that, in all the important clinical trials on which hypertension therapy is based, blood pressure measurements were made not by doctors but by nurses or machines. Furthermore, the BP measurements were made according to strict standards -standards that require up to 15 minutes in order to get an accurate measurement. The standards for BP measurement, for instance, include a 5 minute "resting" period, two measurements in the right arm and one in the left, and allowing at least 1 minute between measurements. No doctor in the history of the world, DrRich suspects, has done that. These are the standards for measurement on which the recent hypertension treatment guidelines are based. Unless a patient's BP is measured according to these standards, the wrong number might well be obtained, and treatment might be inappropriately given or withheld.
The point the authors are trying to make here is that measuring BP accurately is critical to appropriate therapy, but that doing so is not as easy or quick as most doctors think. The American Heart Association is preparing to publish new guidelines for measuring BP, stressing the importance of doing it the right way. The Mayo doctors, one suspects, are merely firing a shot over the doctors' bow, to prepare them for the necessity of changing their longstanding practices and procedures for the measurement of BP.
