In respect of high blood pressure, medical practitioners are coming to the view that many people have been misdiagnosed and given powerful medication unnecessarily. How is that highly trained physicians are doing this?
Diagnosing hypertension is not as straightforward as having a sphygmomanometer test in your doctor’s office. Yet, traditionally it is on the basis of that one measurement that doctors have based their diagnosis even though there are a variety of factors that determine our blood pressure at any given time. How do you know if you suffer from the condition?
Our blood pressure is not constant
Our blood pressure varies from minute to minute depending on:
- what time of day it is;
- what we are doing;
- whether we are stressed or under pressure;
- taking or have just taken physical exercise;
- have recently drank a caffeinated beverage or smoked cigarettes; and
- even how the measurement is taken can affect the reading – when the nurse takes my readings, my blood pressure is always lower than when a doctor takes the readings.
Blood pressure rises naturally when our body needs more blood. To get an accurate reading we need to be relaxed. It’s our readings at rest that matters. Many people are not relaxed when they visit their doctor’s office and that influences the readings; some are so stressed it makes any readings meaningless.
Multiple readings are required
At least two readings should be taken at intervals before a diagnosis is made. Even if several readings are taken, a true picture may not emerge because the readings are not taken under the same circumstances. It is because of this that research reported in the Journal of the American Medical Association found more than 20% of patients diagnosed with borderline hypertension had in fact perfectly normal blood pressure. Furthermore, on 29th March, 2011 the BBC reported that 37% of the 8,295 patients in the sample who were thought to have stubborn or resistant hypertension actually had “white coat” syndrome.
More and more doctors are now using an ambulatory blood pressure monitor, which takes readings automatically every 15 minutes over a 24 hour period and records them for use as the basis of an accurate diagnosis. This has now been formalised in advice the National Institute for Health and Clinical Excellence to doctors in England and Wales.
The World Health Organisation may have suggested that normal blood pressure is 120/80, but depending on your age, 140/90 could be considered normal, with borderline hypertension being in the range 140 to 150/90 to 95. If you are borderline hypertensive, would you prefer your physician to recommend lifestyle changes before prescribing powerful medication? Of course you would and you would also prefer you doctor to have reliable data on which to base a diagnosis, not just the traditional single reading taken at his or her office
Do you really have high blood pressure?
Asking whether you really have high blood pressure is not a silly question, particularly:
- if you have no symptoms; and
- given the high rate of misdiagnoses both in the UK and USA.
The side effects of some prescription medications can be as bad as or worse than the hypertension they are being used to reduce. Insist on using an ambulatory monitor before any diagnosis is made. Both you and your doctor will then know if you really do have high blood pressure.
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