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.
Advice from the BP Measurement Experts
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:
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.
It’s that time of year again and international dog day is right around the corner on August 26th!
What better way to spend this dedicated dog day than taking your pup to get their blood pressure checked?
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?
In my last blog, I introduced some of the claims and confusion around the NIH Sprint study but today I’d like to clear up the main point of confusion and discuss the actual blood pressure (BP) reading technique used to obtain the SPRINT study’s “research readings”.
We will be examining the SPRINT claims of benefit to medicating to a Systolic BP of 120 mmHg, but that will be for another day. Today the focus is on BP averaging, how it was implemented in the SPRINT study, and why it makes sense even if you aren’t sold on the SPRINT findings.
Designing a better User Interface (UI) and User Experience (UX) for medical devices presents unique challenges not typically present in other products or applications. If you press the wrong button when ordering your mocha latte, you may not get whipped cream. If you press the wrong button when administering medicine through an infusion pump, your patient may overdose. One study showed that infusion pumps account for up to 35% of medicinal errors that result in significant harm. A large percentage of those errors were attributed to poorly designed user interface. For instance: a clinician might have entered “lbs” instead of “kg” for the weight of the patient, or perhaps they did not see a decimal point on the display, or they selected the incorrect dose mode while administering medicine. That is one of the many reasons medical devices must pass through numerous regulatory tests to make sure user errors are minimized.
Should you take medication in order to acheive a Blood Pressure of 120/80? The SPRINT trial (Systolic Blood Pressure Intervention Trial) originally published in 2015 is the NIH’s landmark blood pressure (BP) lowering trial. According to the NIH press release (bold emphasis mine),
"When SPRINT was designed, the well-established clinical guidelines recommended a systolic blood pressure of less than 140 mm Hg for healthy adults and 130 mm Hg for adults with kidney disease or diabetes. Investigators designed SPRINT to determine the potential benefits of achieving systolic blood pressure of less than 120 mm Hg for hypertensive adults 50 years and older who are at risk for developing heart disease or kidney disease." (1)
SunTech announced just last week that a new veterinary blood pressure algorithm is under development. This new algorithm will be fine-tuned for equine physiology and will offer a non-invasive way to measure blood pressure on horses. To make the announcement, SunTech exhibited at the 64th Annual Convention of the American Association of Equine Practitioners in San Francisco. I had the opportunity to attend the convention with the primary goal of better understanding how veterinarians use and measure blood pressure today in their equine patients.
With the launch of SunTech’s innovative PLUS Cuff sizes, here are some of the reasons you should consider changing your blood pressure cuffs. The PLUS Cuffs were designed to specifically target the need to fit a greater range of patients – including bariatric patients, improve measurement reliability, and cut hospital costs and inventory.
On top of reducing the risk of cardiovascular disease, aggressive treatment of high blood pressure has shown effectiveness in mitigating risk of mild cognitive impairment. Mild cognitive impairment is viewed as a potential precursor to Alzheimer’s and dementia. A study showed that when treating patients to reduce systolic blood pressure below 120, as opposed to below 140, the past standard target, the risk of mild cognitive impairment was reduced by 19% comparatively.
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.
On recognizing the fact that fifty percent of the world hypertensive population did not realize they had the condition, the World Hypertension League (WHL) dedicated May 17th to the promotion of hypertension awareness. Since that day in 2005, World Hypertension Day has been celebrated by offering free blood pressure readings through the volunteered efforts of numerous affiliated organizations across the globe.
Ambulatory blood pressure monitoring (ABPM) - a procedure in which a patient wears an automatic blood pressure device for 24 hours as readings are taken every 30-60 minutes - is a widely used hypertension diagnostic tool in many countries, but not the US.
Traditionally, blood pressure (BP) measurement is largely confined to the doctor's office, using manual measurements to provide a snapshot of a patient's blood pressure and cardiovascular risk.
Anyone who has had a stress test knows that stress tests are not easy and can even be painful! The commonly-used Bruce protocol for treadmill exercise tests includes 7 stages of 3 minutes each. The first stage starts at a 10% grade at a speed of 1.7 miles per hour. Each stage increases by 2% and between 5-9 miles per hour. Even though a stress test can last for over 20 minutes, most people don't last longer than seven minutes on the treadmill. However, it is important to keep going as long as possible to collect lots of data and be sure to reach the target heart rate. Each additional minute of a stress test could yield important information about the heart's condition.