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September 2008 Br J Cardiol 2008;15:254-7

10 steps before you refer for: hypertension

Terry McCormack, Francesco P Cappuccio

Abstract

1. Check that the measurement is correct Ensure that they really are poorly controlled by resting the patient for 10 minutes, with the cuff in place to discourage them from standing, before taking at least two measurements, one to two minutes apart. Feel the radial pulse because in arrhythmias such as atrial fibrillation automatic sphygmomanometers are inaccurate and therefore traditional devices such as mercury sphygmomanometers must be used. People aged over 80 years and some diabetics may have postural hypotension. This is where the systolic blood pressure drops 20 mmHg on standing or they may have postural symptoms.2 Having made that diag

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