Millions of individuals with normal blood pressure may be wrongly diagnosed with high blood pressure due to inaccurate positioning during blood pressure measurements, according to new research presented at the American Heart Association's Scientific Sessions conference in Philadelphia. The study, conducted by Dr. Randy Wexler, a primary care physician at The Ohio State University Wexner Medical Center, highlights the importance of proper positioning for accurate blood pressure readings.

Guidelines from the American Heart Association and American College of Cardiology emphasize that patients should be seated with their feet flat on the floor, back supported, and the arm wearing the blood pressure cuff placed at heart level. However, many healthcare professionals measure blood pressure while patients are seated on examining tables, leaving their legs dangling and back and arm unsupported.

Dr. Wexler stated that this improper positioning is not conducive to taking accurate blood pressure readings. Being misclassified with high blood pressure, also known as hypertension, can lead to unnecessary treatment and medication for patients who do not require it. This exposes them to potential side effects, highlighting the significance of accurate measurements.

The study involved 150 adults randomly assigned to different groups. Blood pressure readings were taken on a fixed-height exam table and an examination chair with adjustable positioning. The results were compared to assess the impact of positioning on blood pressure measurements. The average systolic blood pressure reading was found to be 7 mmHg higher on the exam table compared to the chair, while the average diastolic reading was 4.5 mmHg higher. These significant differences could potentially misclassify millions of people as having hypertension when their blood pressure is actually within the normal range.

Dr. Wexler expressed surprise at the extent of the difference in readings between the two positions. The findings, published in the journal eClinicalMedicine in September, highlight the importance of correctly measuring blood pressure to ensure appropriate diagnosis and treatment.

High blood pressure affects nearly half of all adults in the United States, with hypertension diagnosed when readings consistently reach or exceed 130 mmHg systolic or 80 mmHg diastolic. Misdiagnosis can lead to unnecessary medication and the risk of pushing blood pressure too low, resulting in hypotension. Hypotension can cause symptoms like dizziness, lightheadedness, fainting, and an increased risk of falls.

Dr. Jordana Cohen, a nephrologist at Penn Medicine in Philadelphia, who was not involved in the research, emphasized the need for accurate blood pressure measurement to avoid over-treatment or potential harm to patients. Cohen stressed that healthcare systems should prioritize improving measurement techniques to achieve better outcomes.

Dr. Wexler also acknowledged the challenge of managing time constraints faced by healthcare professionals. Primary care providers, who often deal with numerous chronic conditions, may not have enough time during appointments to take blood pressure measurements properly. Future research will explore strategies to ensure efficient and accurate measurements without slowing down the patient visit process.

The study's findings underscore the critical need for healthcare providers to adhere to recommended guidelines for blood pressure measurement. Accurate measurements can prevent misdiagnosis, unnecessary treatment, and potential harm to patients.