Blood pressure gauging errors common, can affect treatment

Almost a third of American adults have high blood pressure, putting them at elevated risk of stroke and heart failure.

A new study by the University of New Mexico College of Pharmacy suggests that imprecise blood pressure monitoring techniques could be compromising hypertension treatment.

For the study, 40 hypertension patients had their pressures measured using both the traditional method and the 2005 American Heart Association updated method, which specifies body position, arm position, cuff placement, and the number of readings. Then a panel of physicians prescribed hypothetical hypertension treatment.

Individual pressure readings varied for 93 percent of the patients. As a result, nearly a quarter of them had conflicting recommendations regarding increasing, decreasing, adding, or discontinuing a medication.

With the traditional method, the most common error was not taking pressure measurements on both arms, presumably to save time. The heart association says to wait five minutes between arm measurements.

"Inaccurate blood pressure assessment is common and may impact hypertension treatment," the authors wrote in last week's Journal of General Internal Medicine. "Clinic staff need to be educated on AHA recommendations."

- Marie McCullough

Working mothers happier, healthier; part time's even better

Mothers who work feel healthier and happier than stay-at-home moms, and part-timers have some advantages over women who work full-time, according to a study published in the December issue of the American Psychological Association's Journal of Family Psychology.

The study, done by Cheryl Buehler and Marion O'Brien at the department of human development and family studies at the University of North Carolina, Greensboro, analyzed data from surveys given at seven time points to 1,364 mothers between 1991 and 2001.

Women who worked said their health was better over most of the time points and reported fewer symptoms of depression during most of the preschool years. Part-time workers exhibited more sensitive parenting than other mothers and gave more opportunities for learning at some points.

Buehler said that working might protect mothers from depression because it reduces social isolation, helps women development social skills that are helpful in parenting, and helps them connect their children to the broader world.

- Stacey Burling

ADHD drugs not linked to cardiovascular risk, study finds

Drugs for attention-deficit/hyperactivity disorder do not seem to cause a higher risk of heart attack, sudden cardiac death, or stroke in adults, a new study finds.

Such a connection had been feared because that class of drugs does cause slight elevations in blood pressure and heart rate.

But in the government-funded study of more than 150,000 users of these drugs, there was no difference in the rates of any serious cardiovascular events when compared with those for nearly 300,000 nonusers. The authors wrote that they could not absolutely rule out an increase in risk, but said it would be modest, if any.

The study was published in the Journal of the American Medical Association. A previous study of children also has found no link between the drugs and the cardiac events. - Tom Avril

Coronary risk the same at sites with, without on-site surgery

If you're getting a coronary procedure at a site without coronary surgery capabilities, there's no special worry about your choice of location.

Past studies have reached conflicting findings about the risk of emergency surgery - or death - for people who get balloon angioplasty or stent placement procedures at facilities without on-site cardiac surgery capabilities.

But a new meta-analysis of studies now concludes that patients at such facilities have no higher risk after all. The rates for patients at centers with or without on-site surgery are much the same, the authors write in the current Journal of the American Medical Association.

Still, additional data are needed, wrote the researchers, led by Mandeep Singh of the Mayo Clinic in Rochester, Minn.

An accompanying editorial notes that successful outcomes are more dependent on the skill of those doing the procedures. Facilities without surgical capabilities need "experienced operators, experienced nursing staff, and clear plans and agreements for rapid transport of patients to a facility" that can do surgery, the editorial said.

- Sandy Bauers