Sunday, March 1, 2015

Hypertension initiative

 The U.S. Department of Health and Human Services announced an initiative the Million Hearts®2014 Hypertension ControlChallenge that aims to prevent 
1 million heart attacks and strokes over five years.

Some of its key blood pressure control tips include:
·       Using a standardized checklist approach to measure blood pressure. 
·       Implementing a self-measured blood pressure program- (sometimes called     home blood pressure monitoring).  
·        Common problems that can account for inaccurate and higher blood      pressure measurements are:

A full bladder                     10-15 mmHg
An unsupported back           5-10 mmHg
Unsupported feet                 5-10 mmHg
Crossed legs                         2-8 mmHg
Cuff over clothing              10-40 mmHg
Wrong size cuff                    high or low
Unsupported arm                   10 mmHg
A conversation                  10-15 mmHg 
Three questions doctors, nurses and other health care provides should ask patients when measuring their blood pressure are:

  •  “Were you rushing to get here or were you physically active right before this appointment?”  Patients should have time to rest before their blood pressure measurement and they should be sitting quietly.
  • “Have you been taking your medication?” Although it self-evident it’s important to make sure if patients take their medication as it was prescribed.
  • “What’s your diet and physical activity regimen like?” If a patient doesn’t eat a healthy diet or abstains from physical activity, find out why. 
The American Medical Association and Johns Hopkins School of Medicine call for physicians and care teams to measure accurately, act rapidly and partner with patients to promote patient self-management.

References: Pickering et al Circulation 2005, O’Brien et al Blood Press Mon 2002

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