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Hypertension diagnosis failures

Patients at high risk of stroke are hugely undertreated for hypertension because of failures in diagnostic practice, a new study reports.

Researchers found patients with previous ischaemic attacks or minor strokes suffered striking fluctuations in blood pressure in the medium term.

The fluctuations meant GPs frequently missed a diagnosis of hypertension because they took too few measurements over too short a time.

Between 32 and 58 per cent of patients with a systolic blood pressure of <140mmhg at="" baseline="" had="" a="" usual="" blood="" pressure="" of="">140mmHg in the following 12 months.

Study leader Professor Peter Rothwell, professor of clinical neurology at the University of Oxford, warned GPs not to be 'falsely reassured' by normal readings, and that 'measuring blood pressure twice, for example at the beginning and end of a consultation, is not reliable'.

He recommended GPs take a minimum of three consecutive measurements to be 90 per cent sure a negative diagnosis was correct.

Professor Gary Ford, professor of pharmacology of old age at the University of Newcastle, said the study would help GPs establish usual blood pressure, 'which is often the most difficult thing in diagnosis of hypertension'.

The results, published online in Stroke, combined blood pressure measurements from over 7,000 patients in three separate UK, Dutch and European trials.

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