Article Impact Level: HIGH
Data Quality: STRONG
Summary of Hypertension, HYPERTENSIONAHA.125.25064. https://doi.org/10.1161/HYPERTENSIONAHA.125.25064
Dr. Leopold Ndemnge Aminde et al.
Points
- Only 14% of over 1,000 online stock images accurately show how blood pressure should be measured according to clinical guidelines.
- Major errors include unsupported backs, un-rested forearms, manual devices, and feet not flat on the floor.
- Images depicting self-measurement were six times more likely to be accurate than those showing healthcare professionals taking blood pressure.
- Accuracy was higher in home settings (25.3%) compared to clinical settings (7.9%), suggesting different error patterns exist.
- Inaccurate online visuals can mislead the public, compromising correct understanding and practice of blood pressure measurement techniques.
Summary
A systematic analysis of 1106 stock photos depicting blood pressure (BP) measurement across 11 major online platforms revealed significant deviations from the 2023 International Consensus on Standardized Clinic BP Measurement guidelines. Overall, only 14.3% (95% CI, 12.3–16.5) of images demonstrated accurate BP measurement techniques. The accuracy varied by platform, ranging from 7.0% (95% CI, 2.9–13.9) on Flickr and Freepik to 27.7% (95% CI, 19.3–37.5) on iStock. Key deviations contributing to inaccuracy included the patient’s back not supported (73%), forearm not resting on a surface (55%), use of a manual instead of an electronic upper-arm device (52%), and feet not flat on the floor (36%).
Accuracy levels differed significantly by setting and assessor type. Images depicting BP measurement in a home setting were more accurate (25.3%) compared to clinical or hospital settings (7.9%; P<0.001). Furthermore, photos showing self-measured BP or BP measured by another person were significantly more accurate than those measured by a healthcare provider (35.4% versus 7.2% versus 13.3%, respectively; P<0.001). After adjusting for the stock photo site, images of self-measurement or measurement by another person had a 6.97-fold higher odds (95% CI, 4.70–10.33) of being accurate compared to measurements by a healthcare provider.
A sensitivity analysis, which excluded the type of device used as an accuracy criterion, showed an overall accuracy of 26.9% (95% CI, 24.3–29.0). This still demonstrated that images of self-measured BP or BP measured by another person were more likely to be accurate compared to those by a healthcare provider (odds ratio, 2.01 [95% CI, 1.46–2.76]). These findings highlight a pervasive issue of inaccurate visual representation of BP measurement online, which has substantial public health implications due to the “picture-superiority effect” and the increasing trend of home BP monitoring.
Link to the article: https://dx.doi.org/10.1161/HYPERTENSIONAHA.125.25064
Reference
Aminde, L. N., Islam, F. M. A., Cheng, V. E., Saad, C., Li, Y., & Schutte, A. E. (2025). Poor accuracy of blood pressure measurement images online: Implications for public health education. Hypertension, HYPERTENSIONAHA.125.25064. https://doi.org/10.1161/HYPERTENSIONAHA.125.25064
