Do physicians measure patients’ blood pressure, and are those measurements reliable?

Ulusoy, Şükrü; Özkan, Gülsüm; Güvercin, Beyhan; Sökmen, Yeliz; Erdem, Yunus

doi:10.1038/s41371-018-0032-7

Cited by 12 publications

(13 citation statements)

References 16 publications

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“…A more systematic use of home blood pressure monitoring (HBPM) by GPs is constantly being advanced by learned societies to improve hypertension diagnosis and control[8–10]. In a great majority of cases, OBP (Office Blood Pressure) measurement is not reliable [11]. In comparison, HBPM is often associated with good hypertensive management, as Verberk and al.…”

Section: Introductionmentioning

confidence: 99%

Implementation of home blood pressure monitoring among French GPs: A long and winding road

et al. 2019

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BackgroundTo explore the perception of home blood pressure monitoring (HBPM) by general practitioners (GPs) in everyday practice in order to identify facilitators and barriers to its implementation in daily practice.MethodsA qualitative study comprising the conduct of six focus groups between October 2016 and February 2017, gathering 41 general practitioners in primary care practice in Lorraine (North Eastern France), with thematic and comprehensive analysis.ResultsThe first reasons given by GPs to explain their difficulties with HBPM (Home Blood Pressure Monitoring) implementation were the usual lack of time, material and human resources. However, all of these motives masked other substantial limiting factors including insufficient knowledge regarding HBPM, poor adherence to recommendations on HBPM and fear of losing their medical authority. GPs admitted that HBPM use could enhance patient observance and decrease therapeutic inertia. Despite this observation, most GPs used HBPM only at the time of diagnosis and rarely for follow-up. One explanation for GP reluctance towards HBPM may be, along with guidelines regarding hypertension, HBPM is perceived as being a binding framework and being difficult to implement. This barrier was more predominantly observed among aging GPs than in young GPs and was less frequent when GPs practiced in multidisciplinary health centers because the logistical barrier was no longer present.DiscussionIn order to improve HBPM implementation in everyday practice in France, it is necessary to focus on GP training and patient education. We must also end "medical power" in hypertension management and turn to multidisciplinary care including nurses, pharmacists and patients.

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Section: Introductionmentioning

confidence: 99%

Implementation of home blood pressure monitoring among French GPs: A long and winding road

et al. 2019

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“…18,21 Furthermore, the ability of physicians to consistently and effectively measure blood pressure correctly has been reported to be poor. 22 In contrast, determining the sonographic PP with pulsed wave Doppler imaging provides objective, measurable, and, as demonstrated in the above cases, repeatable information. Although the apical-4 chamber view is often the most difficult view to obtain in adults because of the body habitus and underlying disease, 23 in our experience, it is relatively easy to obtain in children.…”

Section: Discussionmentioning

confidence: 93%

The Use of Point‐of‐Care Ultrasound to Evaluate Pulsus Paradoxus in Children With Asthma

Kharasch

Jansson

Liteplo

et al. 2020

J of Ultrasound Medicine

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Pulsus paradoxus (PP) is defined as a fall of systolic blood pressure of greater than 10 mm Hg during the inspiratory phase of respiration. Measurement of PP is recommended by national and international asthma guidelines as an objective measure of asthma severity but is rarely used in clinical practice. Cardiac point‐of‐care ultrasound with pulsed wave Doppler imaging measuring respiratory‐phasic changes of mitral valve inflow velocities is well described in cardiac tamponade as “sonographic” PP. We present 10 cases of acute asthma presenting to an emergency department showing the finding of sonographic determined PP in the apical 4‐chamber view of the heart on pulsed wave Doppler imaging.

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“…The bland Altman's analysis also reveals that bias is zero, which corresponds to the zero-measurement error, all data points lie within the limit of agreements and shows the good agreement between pressure readings of two devices. However, the same results were not reproduced during clinical trials, which can also be associated with the accumulation of various errors, such as hearing and concentration variation among individuals while measuring BP, white coat hypertension, and patient anxiety [19].…”

Section: Discussionmentioning

confidence: 94%

Concept, hardware development, and clinical trials of a Galinstan based Mercury free sphygmomanometer – Merkfree

Kumar

Wander

et al. 2022

Preprint

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The aim of this work is to develop Merkfree – a mercury-free sphygmomanometer that looks, feels, and operates just like a traditional mercury sphygmomanometer (MS). For this we use Galinstan as a substitute for mercury, which is a non-toxic alloy of Gallium, Indium and Tin. Galinstan is nearly half as dense as mercury and sticks to class. To work with the lower density, we designed an enclosure and scale that is nearly double the length of MS. The issue of stickiness with glass was resolved by maintaining a small meniscus of a reducing agent in the measuring tube and tank of Merkfree. Clinical trials to validate the accuracy of Merkfree against MS and Oscillometric Sphygmomanometer (OS) were conducted over 252 patients. The results show a good correlation of the systolic and diastolic BP measurements from Merkfree with respect to MS and the OS. The mean absolute percentage error is less than 10% for both SBP and DBP. We also found that Merkfree has lower rounding-off errors compared to MS. Merkfree can be a viable alternative to mercury sphygmomanometer that can help achieve the goal of WHO in eliminating mercury from healthcare, while simultaneously making sure that gold standard technique of sphygmomanometry continues to be available to the clinicians.

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Do physicians measure patients’ blood pressure, and are those measurements reliable?

Cited by 12 publications

References 16 publications

Implementation of home blood pressure monitoring among French GPs: A long and winding road

Implementation of home blood pressure monitoring among French GPs: A long and winding road

The Use of Point‐of‐Care Ultrasound to Evaluate Pulsus Paradoxus in Children With Asthma

Concept, hardware development, and clinical trials of a Galinstan based Mercury free sphygmomanometer – Merkfree

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