[Does this patient have hypertension? Different methodologies in the measurement of arterial pressure]

Recommendations on the techniques for the measurement of hypertension have been published by WHO and the International Society of Hypertension. In order to assess the impact of these recommendations on the clinical practice among physicians, we have conducted a survey using a self reported questionnaire, among 211 hospital internists, 51 hospital cardiologists and 153 general practitioners (GPs). Large differences in the technique for the measurement of blood pressure were recorded within each group of specialists, whereas internists, cardiologists and GPs did not differ as groups. About half of the internists and cardiologists, and about two thirds of GPs reported they usually record the diastolic blood pressure at the fourth Korotkoff phase, while the others use the fifth phase. There was also disagreement on the patient position, sitting or lying, during blood pressure measurement. Physicians dealing with diagnosis and treatment of hypertension do not follow the international Society guidelines. Such differences may partly explain the inadequate control of hypertension in the general population and the increase in the prevalence of heart failure.