TikTok videos about high blood pressure often lack scientific basis

Popular videos offering guidance for living with high blood pressure shared on TikTok frequently focus on alternative medicine and make claims that aren't backed by scientific evidence, according to a study presented at the American College of Cardiology's 71^st Annual Scientific Session.

The study assessed the content of TikTok videos focused on high blood pressure (also called hypertension), one of the most common risk factors for heart disease and stroke among U.S. adults. Researchers found that 42% of videos addressed alternative medicine—more than twice the number that focused on scientifically validated medical treatments—and 14% mentioned products for sale.  

"A lot of the information in these videos didn't have any explicit source mentioned in the video, so viewers might not know if it's coming from a credible source," said Nanda Siva, a third-year medical student at West Virginia University School of Medicine and the study's lead author. "Most of the people who were posting these kinds of videos were not health care providers, and the number of cardiologists was small."

The research team, comprised of medical students from West Virginia University and The George Washington University who were mentored by Arka Chatterjee, MD, Associate Professor of Medicine at the University of Arizona, reviewed a total of 91 videos associated with the hashtags #highbloodpressure and #hypertension on a single day (Oct. 11, 2021). The final videos were chosen from the top 100 videos for each hashtag. Videos that were not in English or related to the medical condition were eliminated.

While nearly 90% of the videos were characterized as educational, a sizeable portion (14%) were categorized as promotional in nature. Diet, a common strategy to control high blood pressure, was mentioned in 43% of videos, but exercise, another essential component of a heart-healthy lifestyle, was mentioned in only 5% of the videos.

Medical treatments were mentioned in 14% of the videos, but 42% discussed alternative medicine approaches such as herbal supplements, acupuncture or massage techniques that have not been shown to improve cardiovascular outcomes in recent large studies. As an example, Siva said that one of the top-ranking videos instructed viewers to rub behind their ear 36 times daily to stabilize blood pressure.

"It's easy for individuals to feed on a patient's desire for an easier fix to their problem or their desire to not use medications," Siva said. "If videos are being made about proven lifestyle changes, or the importance of medication compliance, that's not what's making it into the top 100s on TikTok. That's not what's being shared and being seen."

Researchers were able to use each creator's TikTok profile to identify videos created by an individual with a medical background. Additional searches were performed if the creator's background was unclear. Overall, less than half of the top videos were posted by health care professionals, 22% of whom were physicians and 5% who were cardiologists.

"I think there has to be more emphasis placed on what patients are using to receive information, whether it be social media, YouTube, TikTok or Twitter," Siva said, adding that patients often discontinue medicines due to incorrect information or advice. "As health care professionals, we should recognize that patients are not reading the scientific literature that we're reading. Not only do we have to increase our presence on social media, we have to express this information in a way that makes sense to them."

TikTok allows users to upload and view video clips that are typically 10-60 seconds in length but can be up to 10 minutes in length. With 1 billion monthly users reported, up 45% from mid-2020, TikTok has gained prominence as a major social media platform since its global launch in 2017. Roughly half of users are below age 30, although the researchers did not investigate the age of the viewers of the videos examined in their study. The study was limited by its reliance on video rankings from a single day. The mix of top videos can change rapidly as new content goes viral.

Since health problems, such as hypertension, tend to become more common as people get older, Siva said demographic trends may increase the role of social media as a channel for health information.

"I think it's going to become more and more important as time goes on," Siva said. "As the generation that is getting older is more active on social media, this is the information that they'll be seeing more often. We [health care professionals] have to lead the charge on this because if we fall behind, there's going to be even more misinformation than there already is."