Dear Dr. Donohue: I have a new doctor. My old doctor retired. The new one is quite busy. Here's how my first visit went. The doctor rushed into the room and asked if I had any problems. I said no, but I need a general exam. He grabbed my arm and took my blood pressure faster than it's ever been taken. He said I have high blood pressure, quickly wrote a prescription and told me to come back in a month. I had my sister, a nurse, check the pressure. She got a normal reading. Where does this leave me?
H.H.
It leaves you with one choice - pick another doctor. Perhaps that will wake up your current doctor to the fact that he's not devoting enough time to patients.
Fairly rigid standards have been published that guide how blood pressure must be taken. Only by following those rules is an accurate reading obtained.
The blood pressure cuff should not be too small or too large. One that's too small gives an erroneously high reading. One that's too big gives a falsely low reading.
The patient should have been seated comfortably for five minutes before pressure is taken, with legs uncrossed and feet on the floor. He or she should not have drunk any caffeine or smoked a cigarette for 30 minutes before pressure is recorded.
At the first visit, blood pressure in both arms has to be measured, and two bloodpressure readings should be taken with a two-minute break between the recordings. If there's a difference between the pressure in the right and left arms, the higher reading determines the true blood pressure.
The arm should be at heart level and comfortably supported by an adjacent table or the examination table. Unless the pressure is extremely high, no medicine is prescribed until a second visit one or two weeks later.
Admittedly, all the rules can't be observed all the time; they should be for the majority of times.
