A Cross-sectional Survey to Evaluate Adherence to Blood Pressure Measurement Practices among Physicians

A BSTRACT Context: Accurate blood pressure (BP) measurement is fundamental for hypertension diagnosis and management, yet guideline-recommended practices are inconsistently implemented. Aims: This study aimed to assess the practices, availability, and barriers related to appropriate BP cuff selection among physicians in India. Settings and Design: A cross-sectional e-survey was conducted among 7251 physicians practicing across India from June 2025 to September 2025. Subjects and Methods: Data were collected on cuff availability, measurement techniques, and procedural barriers using an electronic questionnaire. Statistical Analysis Used: This study was designed as a descriptive analysis. Data were summarized using descriptive statistics and presented as frequencies and percentages for categorical variables. No inferential statistical tests were performed. Results: While 65% of physicians reported routinely measuring arm circumference, only 48% had access to multiple cuff sizes. A strong association was observed between cuff availability and measurement practices: 93% of physicians with multiple cuffs measured arm circumference versus 39% without adequate cuff availability. Medium cuffs were predominantly used (63%), with availability significantly influencing cuff selection. Critical gaps were identified: 64% used incorrect cuff sizes when proper sizes were unavailable, 36% reported inability to procure needed cuffs, and only 33% consistently ensured direct skin contact during measurement. Conclusions: This study reveals a significant equipment-practice gap in BP measurement, characterized by inadequate cuff availability leading to compromised measurement techniques and failures in accurate BP measurements. These findings highlight the urgent need for systemic interventions to ensure adequate resource allocation and reinforce standardized practices to improve hypertension management accuracy.