After rushing to make your appointment, your name is called to be seen by the doctor. You are escorted to a room, where you sit on a table wrapped in crinkly white paper to have your temperature and blood pressure measured. Although a familiar scene, nurses at the University of Virginia Health System have confirmed a major problem with this scenario.
According to a new study from a team of nurses headed by Melly Turner, R.N., systolic blood pressure can be an average of 14 points higher when taken immediately after arriving in the exam room and sitting on an examination table rather than sitting in a chair with your back supported and feet flat on the floor. In fact, all study participants had lower systolic and diastolic blood pressure measurements when seated in a chair versus the exam table.
With a desirable blood pressure reading around 120/80, and the American Heart Association’s definition of hypertension as 140/90 or greater on two consecutive tests, a 14-point difference can mean the difference between a clean bill of health and an inaccurate diagnosis.
“Currently, most patients get called back for their appointment, sit on the table, and immediately get their blood pressure measured,” Turner said. “Our study reaffirmed the American Heart Association’s technique that patients should sit in a calm environment with feet flat on the floor, resting their back against the chair for at least five minutes before taking a blood pressure measurement on a bare arm at heart level. All too often, this doesn’t happen. “
In the first study of its kind conducted by nurses, the group found that taking a blood pressure reading in a chair after at least five minutes of waiting provided more accurate results than the traditional approach. Turner’s team even factored in anxiety when seeing a doctor, or the “white coat syndrome” into their research. White coats did not result in any statistically significant differences as compared with health care personnel wearing scrubs or street clothes.
“Patients should know what their blood pressure is. If they have a diagnosis of high blood pressure, they need to know what the goal of their blood pressure should be, and how to get it there. This requires making necessary lifestyle changes, such as eating a balanced diet, lowering fat intake, lowering salt and sodium intake, in addition to incorporating at least 30 minutes of physical activity into their schedule most days of the week,” Turner said.
The American Heart Association estimates that nearly one-third of Americans have high blood pressure, which can lead to stroke, stiffness of the heart over time, and an enlarged heart if untreated.
Revision date: July 6, 2011
Last revised: by Janet A. Staessen, MD, PhD