When we take out the blood pressure cuff, the look my clinical staff and I get from patients who aren’t established in my practice is something to behold. Quite frankly, I’m bewildered by how often we get comments along these lines:
Why are you taking my blood pressure?
I’ve never had my blood pressure taken at the dental office before.
My old dentist never took my blood pressure.
Is this something new because of COVID?
Patients question us over and over, and it’s something that needs to be addressed.
First of all, if you take blood pressure on your patients when they walk through your door, fist bumps to you. If you don’t, then it’s time to change things up and invest in some blood pressure cuffs ... or dust off the ones you have that are sitting around in a drawer or cupboard. You’re taking temps, right? Of course you are, and willingly so! So, there should absolutely be no reason for you not to be taking your patients’ blood pressure. Keep reading.
Let’s look at some sobering stats, because numbers always put things into perspective. This is from the Centers for Disease Control and Prevention (CDC),1 and the link to the webpage is here:
- In 2018, nearly half a million deaths in the United States included hypertension as a primary or contributing cause.
- Nearly half of the adults in the United States (108 million, or 45%) have hypertension defined as a systolic blood pressure ≥ 130 mm Hg, or a diastolic blood pressure ≥ 80 mm Hg, or are taking medication for hypertension.
- Only about one in four adults (24%) with hypertension has their condition under control.
- About half of the adults (45%) with uncontrolled hypertension have a blood pressure of 140/90 mm Hg or higher. This includes 37 million US adults.
- About 30 million adults who are recommended to take medication may need it to be prescribed and to start taking it. Almost two out of three of this group (19 million) have a blood pressure of 140/90 mm Hg or higher.
- High blood pressure was a primary or contributing cause of death for more than 494,873 people in the United States in 2018.
- High blood pressure costs the United States about $131 billion each year, averaged over 12 years from 2003 to 2014.
Wow. Just wow. And those are the ones who are diagnosed. What about the ones who aren’t? That’s where we come in. Whether it’s with our established patients or those who come to us on a limited/emergency basis, these patients need to be screened.
High blood pressure is painless, but lack of pain doesn’t mean there isn’t anything wrong. Some call it the “silent killer.” I would have to agree. No sugarcoating here.
In 2019, the total number of deaths was 2,854,838.2 Of those deaths, the number one cause was heart disease. Stroke, diabetes, and cancer were among other causes of death (see figure 4 at this link).2 When you study the aforementioned blood pressure stats, you can see why this is a big deal. I don’t think I can be any more black-and-white than that.
Let’s be candid. It takes about one minute to take a person’s blood pressure. Another minute to have a discussion with them if it’s abnormal/high, and perhaps another minute to write a referral to their general practitioner for an assessment. Furthermore, with the indirect effects of COVID-19 (mental, physical, and general personal well-being), our role in the care, assessment, and potential intervention in our patients’ overall health is even more vital. I have a feeling that things are going to get worse before they get better, as we continue to manage the residual impacts of COVID-19.
Enough said. Make it happen and keep me posted on your clinical experiences—COVID-19 or non—because if your clinical life is vanilla, it’s time to shake things up.
Cheers! S
Listen to more in this video from Dr. Stacey Gividen at this link.
References
- Facts about hypertension. National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. Centers for Disease Control and Prevention. Updated September 8, 2020. Accessed January 20, 2021. https://www.cdc.gov/bloodpressure/facts.htm
- Kochanek KD, Xu J, Arias E. Mortality in the United States, 2019. NCHS Data Brief No. 395, December 2020. Centers for Disease Control and Prevention/National Center for Health Statistics. Updated December 22, 2020. Accessed January 20, 2021. https://www.cdc.gov/nchs/products/databriefs/db395.htm#:~:text=Data%20from%20the%20National%20Vital,2018%20to%20715.2%20in%202019
Editor’s note: This video first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles at this link and subscribe here.
Stacey L. Gividen, DDS, a graduate of Marquette University School of Dentistry, is in private practice in Hamilton, Montana. She is a guest lecturer at the University of Montana in the Anatomy and Physiology Department. Dr. Gividen is the editorial co-director of Through the Loupes and a contributing author for DentistryIQ, Perio-Implant Advisory, and Dental Economics. She serves on the Dental Economics editorial advisory board. You may contact her at [email protected].
