Blood pressure tests for under 35s may be misleading

Main Category: Hypertension
Article Date: 16 Apr 2004 - 0:00 PST

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Blood pressure tests for under 35s may be misleading, doctors who routinely measure blood pressure in people under 35 are more likely to misdiagnose than to detect hypertension correctly, according to a study in this week's BMJ (British Medical Journal www.bmj.com). This could lead to unnecessary lifelong treatment for many.

Blood pressure naturally varies a great deal from day to day. British guidelines currently recommend that doctors check all their patients' blood pressures but because of the natural variation, it is frequently overestimated or underestimated. This means that hypertension may be overdiagnosed.

Dr Tom Marshall, a public health expert at Birmingham University, calculated how often hypertension would be diagnosed in over 13,000 people. He then calculated how many were truly hypertensive. He found that routine measurement of blood pressure in people under 35 is more likely to misdiagnose than to diagnose it correctly.

Young adults are at low risk of heart disease and therefore benefit little from treatment. But misdiagnosis could mean a lifetime on medication.

Doctors should diagnose hypertension with caution in young adults, taking the average of many measurements or even using a higher threshold, he concludes.

Contact:
Dr Tom Marshall, Lecturer in Public Health, Department of Public Health and Epidemiology, University of Birmingham, UK Tel (currently based in Boston, USA): Email: t.p.Marshall@bham.ac.uk

To read the full article please go to:
(When measurements are misleading: modelling the effects of blood pressure misclassification in the English population)
http://bmj.com/cgi/content/full/328/7445/933

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