A new study published in Hypertension, an American Heart Association journal, reveals that only 14% of online stock images showing blood pressure measurement follow clinical guidelines, potentially contributing to inaccurate readings in both home and clinical settings. The research analyzed over 1,100 images from major stock photo websites and found that images depicting home monitoring were approximately three times more accurate than those showing professional healthcare settings.
Lead author Alta Schutte, Ph.D., professor of cardiovascular medicine at the University of New South Wales Sydney, expressed concern about the findings. "We expected that about 50% of images would be accurate, however, our findings were worse than expected," Schutte said. "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 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 (23% for healthcare professionals, 18% for patients). Additional issues included mid-arm not at heart level (19%), crossed legs (13%), patient not sitting (5%), and cuff placed over clothing (12%).
The study found significant differences between settings: 25% of home monitoring images were accurate compared to only 8% of images from physician offices, healthcare facilities, or hospitals. 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.
Daniel Jones, M.D., FAHA, chair of the American Heart Association's 2025 high blood pressure guideline writing committee, emphasized the importance of accurate imagery. "This study highlights the importance of using accurate images to demonstrate the proper technique for measuring blood pressure," said Jones, who was not involved in the study. "Home blood pressure monitoring is recommended for patients to help confirm an office diagnosis of high blood pressure and to monitor, track progress and tailor care as part of an integrated care plan."
With nearly half of U.S. adults having high blood pressure according to American Heart Association statistics, the implications of incorrect measurement techniques are substantial. Schutte warned that inaccurate depictions online could lead people to use incorrect techniques at home, resulting in readings that are either too high or too low. This could lead to wrong conclusions about blood pressure status and potentially inappropriate treatment decisions when shared with healthcare teams.
The researchers urge 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 resources to help people learn proper measurement techniques through their educational materials available at heart.org.
