Although taking blood pressure is routine practice inside the doctor’s office, inaccurate readings can occur, often the result of measurement technique or improper patient positioning. One technique that is recommended by the American Heart Association (AHA) and American College of Cardiology (ACC) is blood pressure (BP) averaging. BP averaging is simply the process of taking 2 or more readings and averaging them together.
This article will explore how Baxter vitals signs spot monitors and best practices can minimize inaccurate blood pressure readings.
Small missteps in blood pressure taking technique can lead to inaccurate readings - potentially impacting diagnoses and treatment plans. The following best practices are essential to ensure reliable results. From proper cuff sizing and patient positioning to creating a calm environment, every detail matters.
In the following narrative we will walk through ways to help minimize errors and ensure each reading reflects a true picture of the patient’s cardiovascular health.
Minimize the Impact of White Coat Hypertension
White coat hypertension, also known as white coat effect, occurs when a patient's blood pressure increases due to the stress of being in a clinical setting. This can lead to inaccurate diagnoses and unnecessary treatment. To minimize the impact of white coat hypertension, clinicians should:
- Take multiple blood pressure readings (at least 3-5) in a quiet, private setting
- Use a validated blood pressure monitor that meets the American Heart Association's (AHA) standards
- Allow the patient to rest for 5-10 minutes before taking the first reading to reduce the white coat effect
- Discard the first reading and use the average of the remaining readings to determine the patient's blood pressure status.
“The use of a validated AOBP [Automated Office Blood Pressure] device that can be programmed to take and average at least 3 BP readings should be considered the preferred approach for evaluating office BP. To ensure that the patient and staff members are not talking during the measurement, unattended AOBP may be preferred over attended AOBP”.
2019 the AHA/ACC: "Measurement of Blood Pressure in Humans. A scientific statement from the American Heart Association."
Account for Variability in Blood Pressure
Blood pressure can fluctuate significantly throughout the day, and a single reading may not accurately reflect a patient's overall blood pressure status. To account for this variability, clinicians should:
- Take blood pressure readings at different times of the day (e.g., morning, afternoon, evening)
- Use a 24-hour ambulatory blood pressure monitor (ABPM) to track blood pressure over a 24-hour period
- Average the readings from multiple visits to determine the patient's overall blood pressure status
Reduce the Risk of Misclassification
Blood pressure can be classified into different categories (e.g., normal, elevated, stage 1 hypertension, stage 2 hypertension). Misclassification can occur if a single reading is used to determine the patient's blood pressure status. To reduce the risk of misclassification, clinicians should:
- Use the average of multiple readings to determine the patient's blood pressure status
- Consider the patient's overall health status, medical history, and lifestyle factors when classifying their blood pressure
- Use a validated blood pressure classification system, such as the AHA's blood pressure classification system
Here's why:
In one study, if only one blood pressure reading was used as the basis for diagnosis, 27% of patients in this study would have received improper care:
- 13% of patients would not have gotten the appropriate management and follow-ups
- 14% would have been managed more aggressively than needed.
With a single-reading method patients with an elevated blood pressure who require more frequent assessment would have been missed altogether:
- 12 patients who are Stage 1 Hypertensive would have been undiagnosed
- 27 patients would have been misclassified as Stage 2 Hypertensive.
Other Best Practice Guidelines for Taking a BP
The American Heart Association recommends the following best practices for blood pressure measurement:
- Use a validated blood pressure monitor that meets the AHA's standards
- Take multiple blood pressure readings (at least 3-5) in a quiet, private setting
- Discard the first reading and use the average of the remaining readings to determine the patient's blood pressure status
- Use a 24-hour ABPM to track blood pressure over a 24-hour period
- Average the readings from multiple visits to determine the patient's overall blood pressure status
Help limit reading-to-reading variability with blood pressure averaging for a more accurate, holistic picture of your patient’s hypertension status with vital sign's spot monitor's from Baxter/Welch Allyn.
Partner with CME Corp for Baxter Spot Vital Signs Monitors
CME Corp and Baxter have a long-standing history and relationship. Our medical equipment focused account managers work with outpatient clinics to ensure they are equipped with vital signs monitors like Baxter's 44WT-B 4400 Series Spot Vital Sign Spot monitor with built in blood pressure averaging.
After the sale CME biomedical technicians support Baxter vital signs monitors with annual preventive maintenance and repair services.
Click CHAT to talk with CME about maintenance contracts.
About Baxter: Baxter and its subsidiary, Welch Allyn, offer broad portfolios of medical devices and products to healthcare providers worldwide. The comprehensive array of devices and products in these portfolios address a wide range of medical care needs such as diagnostic, critical care, hospital and surgical products, patient monitoring, and physical exams. Capitalizing on Welch Allyn’s 100 years of innovation, 268,000 customers and 100 configurable products, Baxter is uniquely positioned to help transform global healthcare for years to come.
About CME: CME Corp is the nation’s premier source for healthcare equipment, turnkey logistics, and biomedical services, representing 2 million+ products from more than 2,000 manufacturers. With 24 locations strategically positioned across the country and increasing, we are readily accessible to our customers. Our mission is to help healthcare facilities nationwide reduce the cost of the equipment they purchase, make their equipment specification, delivery, installation, and maintenance processes more efficient, and help them seamlessly launch, renovate and expand on schedule.
