| Questions regularly asked are grouped under relevant headings:
General Enquiries
Medical
Website Material
Blood Pressure Measurement
Blood Pressure Monitors
For Manufacturers/Distributors of Blood Pressure Monitors
BHS Membership and Meetings
GENERAL ENQUIRIES
- I am a patient could you give me some advice on my condition/medication?
We are unable to handle individual patient enquiries but the Blood Pressure Association, set up especially for patients provides information and support to people with high blood pressure. You can contact them by telephone: 020 8772 4994 or by e-mail via their website www.bpassoc.org.uk
- Can you supply me with literature about hypertension?
The Blood Pressure Association (contact details above) offers a wide selection of leaflets about hypertension.
- What is the prevalence of hypertension in England?
The Department of Health's 'Health Survey for England' published in 2003 provides data on hypertension and is available on their website www.dh.gov.uk
- Can you help me locate research papers on topics related to hypertension?
The BHS is unable to offer a clinical research library facility. However, the internet is a useful resource tool. A website called www.hypertensiononline.com might be of some help.
MEDICAL
- How frequently should urea, creatinine & electrolytes in patients taking Bendrofluazide be monitored?
Renal function and
electrolytes should be measured at baseline prior to the
initiation of medication. If the baseline investigations are
normal, with conventional doses of diuretics, the development
of hyponatraemia or hypokalaemia would be unusual. No studies
have identified the optimal time period over which to monitor
renal function and electrolytes in patients taking long-term
thiazide-type diuretics for the treatment of hypertension.
Routine monitoring of electrolytes would normally be required
on an annual basis. In patients with abnormalities in
electrolytes or renal function at baseline, or in patients in
whom concomitant medication has been added such as an ACE
inhibitor or angiotensin receptor blocker, additional
monitoring might be required following such intervention. It
is difficult to generalise and physician judgement must play a
role in each individual patient.
- In a patient with controlled hypertension. What investigations would be routinely advised at follow up and how often should cardiovascular risk be re-assessed?
The BHS Latest Management Guidelines IV recommend simple routine investigations:
-
Review every 6 months when treatment and blood pressure are stable
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Measure blood pressure and weight
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Enquire about general health and side effects
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Reinforce lifestyle advice and adherence to drug therapy
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Annually, test for creatinine and electrolytes, review glucose and lipid profile (ideally tested). Test for proteinuria.
CVD risk should be recorded annually in patients previously below the risk threshold for treatment.
WEBSITE MATERIAL
- Can you give me a hard copy of the nurses distance learning course?
There are no longer any hard copies available but you can download the course from the BHS website (click here)
- How do I get permission to reproduce material from your website?
Permission is normally granted for educational purposes as long as it is accurately
reproduced and the source is acknowledged. If the material has
been published, then permission should also be sought from the
relevant publisher. If you need further information please contact the
Information service Tel 07717 467973 e-mail bhs@le.ac.uk
- Where can I find an up-to-date CVD risk calculator on the BHS website?
There is currently no CVD risk calculator available. As soon as a suitable calculator is developed, it will be posted on the website.
BLOOD PRESSURE MEASUREMENT
- Do you have any guidelines on the correct way to measure blood pressure?
Yes, this topic is covered in a Factfile (click here) and in the BHS Latest Management Guidelines (click
here). It is also covered in a tutorial CD which you can download from the BHS website (click
here). There are posters which also show 'How to Measure Blood Pressure' with an automatic device and also with a mercury sphygmomanometer (click here).
- How many readings do I have to take when measuring blood pressure and how do I record them. Which one do I use?
Two measurements should be taken (1-2 minutes apart), the initial value being discarded
if there is a large (>10mmHg) difference between the first and subsequent readings and further measurements made.
- When measuring blood pressure, should the tubes of the cuff bladder be pointing up or down?
If you are using a manual blood pressure monitor, it is sensible to position the tubes
to the top of the cuff so that they don't interfere with the stethoscope. If you are using an automatic device then it doesn't matter which
way up you use the cuff. Some cuffs are conically shaped i.e. larger at the top than the bottom to fit the shape of the upper arm. In this case there is only one way to fit with tubes downwards.
- How do I know which cuff size to use?
The bladder of the cuff should fit around at least 80% of the arm but not more than 100%. A cuff that
does not fit properly will not give an accurate reading so it is important to use the right size.
- A large cuff is still too small. What should I do?
Contact the manufacturer of the blood pressure monitor. They may be able to supply an extra large cuff. Manufacturers/distributors
of BHS recommended devices can be found at the end of the blood pressure monitor listings on the BHS website (click here)
BLOOD PRESSURE MONITORS
- Can you recommend a blood pressure monitor for me to purchase? Where can I buy it?
There is a list of BHS approved monitors
on the website (click here). At the end of the list are details of the
distributors/manufacturers. They will be able to give you a list of stockists in your area and current prices.
- How do you select blood pressure monitors for your recommended list?
The BHS Blood Pressure Monitor Working Party will consider the report of a clinical
validation study on a blood pressure monitor that has been published in a peer journal. If the study has been
performed strictly in accordance with either the BHS Revised Protocol or the International Protocol and the device has been
shown to give accurate readings, then the Working Party will approve the device for inclusion in the list on the BHS website.
- The blood pressure monitor I want to buy is not on your list of recommended devices. Why not?
As far as the BHS is aware, there has been no published report on a validation study
performed on the monitor against either the BHS Revised Protocol or the International Protocol. Therefore, the BHS has
not been able to approve the device in question and cannot include it in the recommended list.
- How often should my blood pressure monitor be calibrated/serviced and who can do this for me?
Blood pressure monitoring devices should be serviced and/or recalibrated every 6-12 months. The manufacturer should be able to do this for you.
- Is it still OK to use mercury and aneroid blood pressure monitors?
Whilst mercury sphygmomanometers are gradually being phased out, they are
still considered to be the gold standard and can still be used. Aneroid monitors can also be used as long as they are regularly
calibrated (every 6 months) as they have a tendency to loose accuracy with use. All blood pressure monitors should be serviced and
calibrated at regular intervals, at least every 6-12 months.
FOR MANUFACTURERS / DISTRIBUTORS OF BLOOD PRESSURE MONITORS
- How can I get a blood pressure monitor added to the BHS recommended list?
You must first have the blood pressure monitor independently validated using the set criteria (click
here). There are several centres around the country that will perform the study for you. You can find these by researching previous validation studies which have been published in relevant journals.
The BHS is currently setting up a validation service which should be up and running soon. Please contact the Information Service by e-mail bhs@le.ac.uk or by phone 07717 467973 for details.
BHS MEMBERSHIP AND MEETINGS
- How do I become a member of the BHS?
The Society is open to hypertension researchers in the United Kingdom and the Republic of Ireland.
It is limited to 250 members and includes clinicians, nurses, physiologists and other scientists. The annual subscription fee is currently £50.00.
Applications for membership are considered on an annual basis, at the Annual Business Meeting held in mid September each year. There are no formal application forms.
A full curriculum vitae including a list of publications, together with supporting letters from two members of the Society, should be sent to the Secretary
(please see under 'More About Us' for contact details), no later than three months before the Annual Business Meeting, i.e. by the middle of June. Applicants will be contacted at the end of September regarding the outcome of their application.
- How do I register to attend one of the BHS educational meetings?
Attendance at the BHS Annual Scientific Meeting in September is limited to BHS Members and their named guests. Non-members are welcome to attend other BHS educational meetings,
such as the BHS Clinical Education Meeting for Primary Care and the BHS Masterclasses, depending on availability. Please visit the Courses and Conferences section of this website for more details.
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