Thursday 23rd May 1991   Morning surgery 11:20

“I am very worried about this gentleman’s blood pressure, Dr Dennis. It’s 160/100.”
“No, it’s not, Dylan. It’s 140/80.”
“I checked it in his right arm, Dilys and you checked it in the left arm. The British Hypertension Society recommend checking the blood pressure in both arms then taking the highest reading.”
“But you checked it as soon as Mr Pemberton came into the room, Dylan. You hardly gave him time to sit down. I had a little chat with him before I checked his blood pressure. He was quite relaxed by then.”
“Dr Dennis doesn’t have time to hang around having a little chat every time he checks someone’s blood pressure, Dilys.”
“And you pumped the cuff up really tightly. I could see it hurt him.”
“You have to do that because of the auscultatory gap.”
“No, you don’t, Dylan. If you want to check for an auscultatory gap, you are supposed to feel the radial pulse while you pump up the cuff.”
“I am not sure that I believe in the auscultatory gap,” my Dad said. “There are a lot of things about blood pressure that we don’t really understand.”
“Listen, Dr Dennis, can you check Mr Pemberton’s blood pressure so we can see what it really is?”
“There’s no point in me checking it, Dylan. It’s bound to be very high now he has heard both of you bickering.”

“Look, Mr Pemberton,” my Dad said, “I think it is reasonable to assume that your blood pressure is somewhere between the 2 figures; let’s say 150/90. In my book, that’s not too bad. I suggest we continue the same medication and check it again in 2 months.”

 

The auscultatory gap.
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