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BP kit check urged as NICE allows home monitoring

BP kit check urged as NICE allows home monitoring


One in seven general practice blood pressure (BP) machines may be inaccurate, a study claims.

Research published in the British Journal of General Practice (BJGP) surveyed more than 80 general practices and found 14% of the sphygmomanometers tested did not meet the British Hypertension Society standards.

It is argued this could lead to inaccurate BP readings.

Professor Roger Jones, BJGP Editor, said: "Measuring blood pressure and treating high blood pressure are important tasks for clinicians and nurses, and ensuring the accuracy of these measurements is vital.

"We hope this study will prompt general practices to check that their equipment is up to standard."

Low-cost aneroid machines were found to be particularly inaccurate and the study suggests they should be replaced with digital devices.

This comes as the National Institute for Health and Clinical Excellence (NICE) recommends that diagnosis of primary hypertension can be confirmed by patients monitoring their blood pressure at home or using 24-hour ambulatory BP monitoring (ABPM), rather than based solely on measurements taken in the clinic.

The recommendation draws on new evidence suggesting that ABPM is more accurate than both clinic and home monitoring in defining the presence of hypertension, and that implementation of a diagnostic strategy for hypertension using ambulatory monitoring following an initial raised clinic reading would reduce misdiagnosis and be cost-saving for the NHS.

Professor Richard McManus, a GP and Professor of Primary Care Cardiovascular Research at the University of Birmingham, said: "These guidelines will mark a significant change in the way that we diagnose hypertension.

"The use of ambulatory monitoring will ensure quicker and more accurate diagnosis that will be better for patients and better for the NHS.

"This represents an exciting advance which I am sure will be taken up internationally."

Shelly Mason, a patient and carer representative and NICE Guideline Development Group member, said: "Patients will feel engaged and empowered, and be confident they are receiving the best possible care to manage their hypertension."

Your comments (terms and conditions apply):

"There is a hope that by improving the accuracy of the monitor, it will be possible to improve the care of the patient. But over a quarter of patients have a stressor response to having their blood pressure taken in the surgery - i.e. referred to as whitecoat hypertension. We already seek to work in partnership with patients - if home readings are lower than clinic readings then we do a 24 hour Bp reading. In my opinion, no GP will trust a single reading, no matter how accurate the sphygmomanometer is" – Nigel Roper, Essex


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