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Advice from the BP Measurement Experts

How to Talk to Your Patients about Ambulatory Blood Pressure Monitoring

doctor-patient-education

The rate of Ambulatory Blood Pressure Monitoring (ABPM) studies is on the rise with more and more clinical organizations recommending ABPM for routine hypertension. While patients are familiar with office and home blood pressure monitors, ABPM remains a relatively unknown procedure. How do you explain ABPM to your patients and ensure you get the compliance you need for accurate diagnosis and treatment?

A patient with high BP readings in the office is a prime candidate for ABPM to confirm diagnosis of hypertension. The American Heart Association recommends either ABPM or home blood pressure monitoring (HBPM) for most patients with high in office BP readings.  

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Can Sleep Quality Impact Your Blood Pressure?

Could poor sleep or not enough sleep lead to an increase in your blood pressure (BP)? It’s not fully understood how and why, but it’s thought that sleep helps regulate stress hormones and helps your nervous system to remain healthy.  Over time, lack of sleep could hurt your body’s ability to regulate stress hormones, leading to high blood pressure (hypertension).1

Dr. Michael Grandner, Director of the Sleep and Health Research Program at the University of Arizona, says, “Hypertension is a key cardiovascular risk factor.  There are now many studies that have been able to show that insufficient sleep and poor sleep quality are related to the development of high blood pressure and other aspects of heart disease.”  Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts. Those with this disorder have been found to be at higher risk of hypertension.2

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New SunTech ABPM Reimbursement FAQ for 2020

 

doctor on laptop

Revisions to CMS guidelines on ABPM reimbursement make it the perfect time to offer 24-hour out-of-office blood pressure measurement to your patients. For more information on reimbursement, see our 2020 ABPM Reimbursement FAQ.

 

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A Surprising Number of Clinicians Fail to Accurately Measure Blood Pressure

 

clinician frustrated about blood pressure results

A surprising number of clinicians fail to accurately measure  blood pressure according to a recent joint survey of more than 2,000 healthcare professionals conducted by the AMA and the American Heart Association. One of the most striking highlights were only 1 in 10 medical assistants were able to answer all 6 of the best-practice in blood pressure (BP) measurement questions.

 


According to American Medical Association (AMA) president Dr. Patrice, Harris, “Hypertension is a leading risk factor for heart attacks, strokes and preventable death in the U.S. Inaccurate blood pressure readings can lead to diagnosis errors, which means getting an accurate reading is vital to treating the condition.”

A recent study published in the journal Hypertension found an increase in high blood pressure (hypertension) cases during pregnancy. By reviewing CDC data on >151 million women between 1970 and 2010, the researchers found a 6% yearly increase in hypertension. The implications being complications for the mother, such as preeclampsia, or an increased risk of preterm birth.

Although the need for accurate BP measurement is clear, the joint survey showed the gap in BP knowledge that many healthcare professionals have. The most frequently missed best-practice question was about proper cuff-wrap-inflation, followed by proper brachial artery cuff position. Both factors are critical to getting an accurate BP reading. Even though the healthcare professionals surveyed were aware of the opportunities for error in BP measurement, BP refresher training is reported to be infrequently held.

The same AMA-AHA survey suggested that healthcare professionals believe up to 41% of BP measurements taken across all medical practices are less than 100% accurate. Although the overall error rate was acknowledged, most respondents felt that their practice was better than the norm.

To ensure an accurate reading, consider these 10 factors that can affect blood pressure readings and advice from our Clinical Manager:

  • If you have a wound, do not apply a BP cuff over, as this can cause further injury.
  • If you have had a single mastectomy, do not apply a BP cuff to the arm on that side. In the case of double mastectomy, use the side of the least dominate arm.
  • Too frequent BP measurements can cause injury due to blood flow interference.

Additional Resources:

To learn more about the basics of BP, see this TedEd on How blood pressure works by Wilfred Manzano.

Want to try your hand at taking a BP reading? Check out this BP simulation.

Sources:

https://www.ama-assn.org/press-center/press-releases/new-research-shows-need-re-training-blood-pressure-measurement

https://www.modernhealthcare.com/safety-quality/ama-aha-look-retrain-physicians-measure-blood-pressure

https://www.washingtonpost.com/health/a-growing-problem-pregnancy-vs-high-blood-pressure/2019/11/08/0ff37238-fb52-11e9-ac8c-8eced29ca6ef_story.html

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New Guidelines for Measuring Blood Pressure from the American Heart Association

 

American Heart Association Logo

The American Heart Association just released a scientific statement on blood pressure (BP) measurement that outlines new guidelines for accurately measuring blood pressure. This is the first time the AHA has made significant updates to their recommendations since 2005. In the statement they describe and compare different methods of measuring BP and make many recommendations. What are the key points that a physician should learn from this new paper?

 

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New Measures for Blood Pressure and Cardiovascular Health

 

Simulation of Blood Vessels in a Vein

Gone are the days where your cardiovascular health could be summed up in two numbers. Systolic and diastolic blood pressure, measured at the brachial artery, were the key tools for staving off heart attack, stroke and other cardiovascular disease (CVD). Have a BP of under 140/90? Great! You are going to live a long and healthy life. Over 140/90? Time to watch your salt and medicate away. While lowering BP in hypertensive patients has been proven to be an effective intervention, it may not be so simple any more. Research, such as the SPRINT study, are finding benefits for managing BP in pre-hypertensive patients. With that, a new series of indices and measurements are offering more tools for doctors to measure and treat hypertension.

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