Patients will be sent home to test blood pressure as millions 'misdiagnosed by GPs'
One in four under 40s give a misleadingly high reading due to 'white coat nerves'
Patients suspected of having high blood pressure will be sent home to test themselves for an extra 24 hours to make sure they were not misdiagnosed in the doctor’s surgery.
The additional tests follow concerns that some are being wrongly diagnosed because their blood pressure rises in the surgery - so-called ‘waiting room nerves’.
Currently, anyone suspected of having high blood pressure is diagnosed by a GP with an inflatable arm cuff.
They then have additional readings, but always at their surgery or in hospital.
Under new draft guidelines, which are open to consultation, the National Institute for Health and Clinical Excellence proposes doctors do not rely solely on readings taken in their surgeries.
Instead, after the initial assessment a patient should be sent home and asked to wear an ambulatory blood pressure monitoring, or ABPM, device.
This is an inflated arm cuff which takes spot readings over a 24-hour period. Around eight million people in Britain are currently diagnosed with high blood pressure, and at least six million are on drug treatment, with the majority aged 50 and over.
But experts say that up to a quarter of those under 40 are misdiagnosed because they develop ‘white coat hypertension’ in which their blood pressure gives a misleadingly high score because they are nervous.
The new guidelines will not change the threshold for treatment but provide an additional check to make sure no-one is incorrectly labelled as having high blood pressure.
In 2008, 32 per cent of men and 29 per cent of women in England had high blood pressure – defined as a systolic blood pressure of 140mmHg or over, or a diastolic blood pressure of 90mmHg or over – or were being treated for the condition.
Under the Nice guidelines, if blood pressure measurements taken during a consultation are 140/90mmHg or higher, then extra confirmation should be obtained over 24 hours at home.
Bryan Williams, professor of medicine at the University of Leicester, led the development of the guidelines.
He said doctors currently have to bring patients back to the clinic twice or more to get an accurate reading.
‘As many as 25 per cent of young people might record having high blood pressure when they go to the doctor when they actually don’t have it,’ he added.
‘When you are older, you are more likely to be hypertensive but, if you are at the margins and particularly if you are younger, then there’s a big error rate with diagnosis.
‘Evidence shows that if you used ambulatory testing before you treat, you would get the correct diagnosis more often.’
He said the guidance was not just cost-effective, but was cost-saving in the long run as less cash is spent on treatments.
He added: ‘What we want to do is ensure that the treatment goes to those people who need it
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