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The Rational Clinical Examination
JAMA. 1995;273(15):1211-1218. doi: 10.1001/jama.1995.03520390071036

Does This Patient Have Hypertension?

How to Measure Blood Pressure

  1. Richard A. Reeves, MD, FRCPC
  1. From the Division of Clinical Pharmacology, Department of Medicine, and the Clinical Epidemiology Unit, Sunnybrook Health Sciences Centre, University of Toronto (Ontario). Dr Reeves is now with Bristol-Myers Squibb Pharmaceutical Research Institute, Princeton, NJ.

Since this article does not have an abstract, we have provided the first 150 words of the full text.

Excerpt

Is This Patient's Blood Pressure Really Elevated? A 46-year-old man who has recently moved to your neighborhood presents with a painful ankle sprain. Before he leaves, you decide to check his blood pressure (BP) and obtain an initial reading of 164/102mm Hg. He denies having high BP previously.

WHY IS ACCURATE BP MEASUREMENT IMPORTANT? Elevated arterial BP, or hypertension, is important because it is common, it is clinically silent, it leads to cardiovascular disease (CVD), and it decreases life expectancy. Because surveys find that approximately 20%1-3 of North American adults have an elevated BP (systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg) or are taking antihypertensive medication, physicians are advised to check all patients periodically for BP elevation.3-7 On the other hand, overestimation of BP can erroneously label people as hypertensive and potentially result in unnecessary dietary restrictions, exposure to potential side effects

Footnotes

  • Reprint requests to Bristol-Myers Squibb Pharmaceutical Research Institute, PO Box 4000, Princeton, NJ 08543 (Dr Reeves).

  • The Rational Clinical Examination section editors: David L. Simel, MD, MHS, Durham Veterans Affairs Medical Center and Duke University Medical Center, Durham, NC; Drummond Rennie, MD, Deputy Editor (West), JAMA.

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