Training Staff to Accurately Measure Blood Pressure

Blood pressure measurement is the most common test performed in a clinical setting and is the first step in assessing cardiovascular health. While there are multiple protocols for obtaining an accurate blood pressure measurement, research has shown that they are rarely followed in daily clinical practice.¹ 

Accurately assessing blood pressure is important because small inaccuracies can have consequences for patients. Underestimating true blood pressure by 5 mm Hg could mislabel a patient with prehypertension when true hypertension is present. Overestimating true blood pressure by 5mm Hg would lead to inappropriate treatment with antihypertension medications.²

Some of the reasons for inaccurate blood pressure measurements include:

• Cuff being too small or the cuff is placed over clothing
• Arm is above or below heart level
• Patient did not rest for 3-5 minutes prior to measurement
• Legs are crossed
• Back and feet are not supported
• Patient talks during the blood pressure measurement

MaineHealth is committed to training staff on accurate blood pressure measurement techniques. Between 2009 and 2018, MaineHealth has trained over  2,000 people on how to accurately measure blood pressure.

Between 2016 and 2018, MaineHealth distributed over 100 hypertension control toolkits to physician office staff. The toolkits provide resources and tools to further assist practices in helping patients control hypertension.

New Guideline for High Blood Pressure

The American College of Cardiology and the American Heart Association recently released a new guideline for the detection, prevention, management and treatment of high blood pressure. 

The new guideline lowers the definition of high blood pressure to 130/80mm Hg rather than 140/90mm Hg to account for complications that can occur at lower numbers and allow for earlier lifestyle and medication interventions. 

MaineHealth supports the change in guidelines and will be updating relevant blood pressure trainings, patient education and clinical tools to reflect the definition of hypertension.

¹ Rakotz, Michael et al. "Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge." Journal of Clinical Hypertension 19, no. 6. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488302/

² Handler, Joel. "The Importance of Accurate Blood Pressure Measurement." The Permanente Journal 13, no. 3. (2009). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911816/