Published 10 July 2009, doi:10.1136/bmj.b2669
Cite this as: BMJ 2009;339:b2669

Head to Head

Is systolic blood pressure all that matters? No

¹ Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland

Peter Sever (doi:10.1136/bmj.b2665) argues that abandoning diastolic measurements will improve control of blood pressure, but Eoin O’Brien thinks that we should change the method of measurement instead

The first 150 words of the full text of this article appear below.

Since Riva-Rocci and Korotkoff gave us the technique for measuring blood pressure over a century ago, we have landed men on the moon, encircled Mars, invented the automobile and aeroplane, and most importantly revolutionised the technology of science with the microchip. Why, we might ask, has medicine ignored scientific evidence for so long and perpetuated a grossly inaccurate measurement technique in both clinical practice and hypertension research?¹ And now we have a call from eminent clinical scientists to modify the technique by abandoning measurement of diastolic blood pressure in people over 50 years old.

In fairness there would be an attraction to the argument if we were dependent solely on conventional measurement of blood pressure since the technique is grossly misleading. Firstly, it creates the phenomenon of white coat hypertension, which affects as many as 20% of patients with hypertension diagnosed by conventional measurement.² Secondly, it fails to detect hypertension . . . [Full text of this article]

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Is systolic blood pressure all that matters? Yes

Peter Sever
BMJ 2009 339: b2665. [Extract] [Full Text]

Rapid Responses:

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Is Systolic Blood Pressure All That Matters? No

John S Morley
bmj.com, 14 Jul 2009 [Full text]

Is systolic blood pressure all that matters? No

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