Blood pressure testing in people under 35 often misdiagnosed

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. 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.

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