Doctors warned on single high blood pressure reading

Research finds that one high measurement should be impetus to "ramp up" blood pressure control.

By Andis Robeznieks, AMNews staff. Aug. 16, 2004.

A single elevated blood pressure reading -- particularly an elevated systolic reading -- is a reliable predictor of future problems and should not be dismissed as a fluke.

That is the conclusion reached by William M. Tierney, MD, director of Indiana University School of Medicine's Division of General Internal Medicine and Geriatrics, Indianapolis, in a report recently published in the Annals of Family Medicine.

"As students, we are told that blood pressure can vary greatly, that one should not rely on a single measurement," said Dr. Tierney in an e-mail. "Because our study showed that a single elevated measurement among patients under treatment for hypertension predicts a host of bad outcomes, it gives the physician an impetus -- and perhaps an excuse -- to ramp up blood pressure control whenever there is an opportunity to do so."

According to an Institute of Medicine report last year, 20 million of the 43 million Americans affected by high blood pressure are not treating it; 12 million of those being treated for hypertension still do not have it under control; and hypertension was a primary cause of death for almost 43,000 Americans in 1999.

Dr. Tierney said there were many reasons for undertreatment: patients might not know they have hypertension; some don't seek treatment; some might not take their medications; and doctors could be prescribing insufficient doses of medications.