Study Finds Majority of Online Blood Pressure Images Violate Clinical Guidelines, Risking Public Health

A comprehensive analysis published in Hypertension, an American Heart Association journal, has uncovered alarming inaccuracies in online stock images depicting blood pressure measurement, with only 14% following established clinical guidelines. The study examined over 1,100 images from major stock photo websites and found that these visual misrepresentations could contribute to incorrect readings in both home and clinical environments, posing significant public health risks.

Lead researcher Alta Schutte, Ph.D., professor of cardiovascular medicine at the University of New South Wales Sydney, expressed surprise at the severity of the findings. The research team expected approximately 50% accuracy but discovered that home monitoring images were approximately three times more accurate than those showing professional healthcare settings, with 25% of home images being correct compared to only 8% from physician offices, healthcare facilities, or hospitals.

The analysis identified multiple deviations from the 2023 International Consensus on Standardized Clinic Blood Pressure Measurement guidelines. Common errors included lack of back support (73%), forearm not resting on a flat surface (55%), use of manual instead of electronic devices (52%), dangling feet (36%), and talking during measurement. Additional issues involved mid-arm not at heart level (19%), crossed legs (13%), patient not sitting (5%), and cuff placed over clothing (12%).

Daniel Jones, M.D., FAHA, chair of the American Heart Association's 2025 high blood pressure guideline writing committee, emphasized the critical importance of accurate imagery for public health education. The implications are particularly significant given that nearly half of U.S. adults have high blood pressure according to American Heart Association statistics available at https://www.heart.org. Inaccurate depictions online could lead people to use incorrect techniques at home, resulting in readings that are either too high or too low, potentially leading to wrong conclusions about blood pressure status and inappropriate treatment decisions.

The researchers found that images showing blood pressure measured by patients or other non-professionals were six times more likely to show accurate techniques than those depicting healthcare professionals taking measurements. This discrepancy highlights the need for improved visual education across all healthcare settings. Schutte warned that because people tend to remember images better than words—a phenomenon known as the picture-superiority effect—inaccurate visuals could have serious public health consequences.

The study urges organizations, media outlets, stock photo creators, web developers, medical journalists, and researchers to review their online images to ensure they accurately represent proper blood pressure measurement techniques. The American Heart Association provides educational resources through materials available at https://www.heart.org to help people learn proper measurement techniques, which is particularly important given that home blood pressure monitoring is recommended for patients to help confirm office diagnoses and monitor progress as part of integrated care plans.