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Does This Patient Have Hypertension?  How to Measure Blood Pressure

Richard A. Reeves, MD, FRCPC
JAMA. 1995;273(15):1211-1218. doi:10.1001/jama.1995.03520390071036.
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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


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