By Kristen Lefkus, Marketing Communications Manager
17 FEB, 2022
8 Minutes
Fewer in-person visits means making them count — automated vitals equipment will help diagnose faster and more accurately than improper manual blood pressure measurement techniques.
On a typical day in your practice, each patient gets their vitals checked including blood pressure. While the patient sits down, you’re gathering all the tools for manual measurement including a stethoscope, sphygmomanometer, blood pressure cuff, pulse oximeter, etc.
Since you haven’t seen the patient in a while, you’re conversing with them while applying the cuff over the patient’s shirt and looking at the aneroid gauge. You take one reading and move on to the remaining vitals. During this process, you’re writing down the information in a chart or typing into an EMR. A lot of patients are coming through your practice and this process needs to happen as quickly as possible, especially if you’re understaffed.
By not using proper technique with the manual blood pressure setup of a sphygmomanometer and reading the gauge, you may be putting your patient at risk with incorrect measurements. A misdiagnosis of hypertension can have physical, psychological and economic impacts on your patient.1 With a hypertension diagnosis, your patient will see an increase in insurance costs leading to higher life insurance premiums.2,3,4
These costs can really add up. Compared to those without hypertension, people with hypertension face nearly $2,000 higher annual health care expenses.5 They also earn approximately two and a half times the inpatient cost, nearly twice the outpatient cost and nearly three times the prescription medication expenditures.5 These are serious expenses that could significantly impact someone’s life. Additionally, 20-97% of patients taking antihypertensive medications experience side effects.6 One analysis found that there was an increased risk of hypotension, syncope, and acute kidney injury.7
With these potential high costs and side effects for your patients, the quality and accuracy of your technique matters.
While trying to save time and resources, manual measurement may be easier but improper technique could be costing you more than you think. Something as simple as putting the blood pressure cuff over clothing or not letting your patient rest can add up to an incorrect reading. The ACC (American College of Cardiology) and AHA (American Heart Association) have outlined 7 steps with 19 specific instructions to help you ensure accurate blood pressure readings.8,9
Hypertension costs the US an estimated $131 billion and is a primary or contributing factor in nearly 500,000 deaths each year.10 Nearly half of adults 20 years of age and older in the US (46%) have hypertension or are taking medication for hypertension.11
There are many best practices when taking blood pressure with manual devices such as an aneroid gauge. Is your practice using all of them? There are myriad factors that can cause blood pressure measurement errors on manual screenings:12
| Factor | Change in mmHg (SBP/DBP) |
| Talking or active listening | 10/10 |
| Cuff over clothing | 5-50/-- |
| Cuff too small | 10/2-8 |
| Smoking within 30 minutes of measurement | 6-20/-- |
| Paralyzed arm | 2-5/-- |
| Back unsupported | 6-10/-- |
| Arm unsupported while sitting | 1-7/5-11 |
| Arm unsupported while standing | 6-8/-- |
Another measurement phenomenon is terminal digit preference, resulting in readings ending in 0 or 5 leading to an inaccurate blood pressure measurement. 13, 14 This occurs in >50% of manual blood pressure readings, reduces the precision of the reading as well as the accuracy of a hypertension diagnosis.15
If taken using the steps necessary to ensure an accurate blood pressure reading, obtaining these readings would require an estimated 14 minutes of office time.16, 17 It’s important to have the right techniques in place to make accurate and timely decisions for your patients. Click here for some best practices on how to better identify hypertension.
The healthcare industry has been pushed into the digital age for security, simplicity and innovation. Make it work for you, not against you with tools for better outcomes for your patients and your practice.
A study comparing three different measurement techniques found that a hypertension diagnosis could not be established with 80% certainty using a single clinic systolic blood pressure reading between 120-157mmHg.18 Even with the right tools, with improper technique you may be putting your patients at risk of misdiagnosis.
Get your practice ahead of the curve – two of the Healthy People 2030 objectives focus on blood pressure including reducing the proportion of adults with high blood pressure and increasing control of high blood pressure in adults.19 These objectives can be made possible with accurate blood pressure measurement through proper technique.
Automated office blood pressure measurement is the AMA preferred in-office approach for measuring blood pressure to increase accuracy, mitigate white coat effect, saving staff time, and more.20 Click here to walk through a manual vs. automated patient journey to see the impact your technique may have on your patients and your practice.
The Spot Vital Signs® 4400 Device helps you capture, access and document patient vital signs so you can focus on what matters most — your patients. Learn more at hillrom.com/spot4400.
