Abstract 13903: Accurate Assessment of Hypertension and Belief in Clinical Readings by Cardiologists

Abstract

Background: The accurate measurement of blood pressure (BP) is essential for the diagnosis & management of hypertension. In clinical practice, BP is estimated using noninvasive methods but there is significant variability in practice, despite guidelines and recommendations for accurate BP assessment. Individual clinical practices implementation of guidelines for BP assessment influence accuracy and clinical certainty of BP measurements. Hypothesis: We sought to assess how BP is assessed in clinical practice of cardiologists and to assess the clinical certainty of the BP obtained in their clinics. Methods: A survey was administered through professional societies that include predominately cardiologists & via Twitter. Assessment of adherence to guideline recommendations for BP assessment was measured and compared to belief and reliability of BP assessment in clinic. Results: 612 surveys were completed in 30 days, 364 completed by cardiologists; 49 (13%) preventive cardiologists. Majority of cardiologists based in United States. 53% routinely check BP in both arms at initial visit, 48% check BP only 1X/per visit; 64% wait 5 minutes before initial BP assessment. Automated BP assessment is used in 58% of respondents’ clinics. 83% trust their BP readings in clinic. Only 23% (85) of all cardiologist accurately measure BP as recommended by guidelines & it is more likely to be done by a preventive cardiologist (P=0.017). For those who do measure BP correctly, 80% repeat BP manually compared with 54% who do not measure BP accurately (P<0.001). For those who perform BP accurately, 86% report trusting their BP readings in clinic, similar to those who assess BP inaccurately (P=0.45). Conclusions: Accurate BP assessment by cardiologists remains suboptimal. Reliability of BP assessment in clinic requires education, implementation of recommendations and empowerment of the entire team to improve BP assessment & results in improved cardiovascular outcomes for our patients.