Principles and Techniques of Blood Pressure Measurement
Section snippets
Location of Measurement
The standard location for blood pressure measurement is the brachial artery. Monitors that measure pressure at the wrist and fingers have become popular, but it is important to realize that systolic and diastolic pressures vary substantially in different parts of the arterial tree, with systolic pressure increasing in more distal arteries, and diastolic pressure decreasing.
The Auscultatory Method
Although the auscultatory method using mercury sphygmomanometer is regarded as the gold standard for office blood pressure
Validation of Monitors
The increasing use of electronic monitors for both self- and ambulatory monitoring has necessitated the development of standard protocols for testing them. The two most widely used have been developed by the BHS27 and the Association for the Advancement of Medical Instrumentation (AAMI) in the United States.28 Both require the taking of 3 blood pressure readings in 85 subjects (chosen to have a variety of ages and blood pressures) by trained observers and by the device being tested. The BHS
Which Measures of Blood Pressure are Clinically Important?
There are potentially 3 major measures of blood pressure that could contribute to the adverse effects of hypertension. The first is the average or “true” level, the second is the diurnal variation, and the third the short-term variability.
Summary
Although the use of mercury sphygmomanometer is regarded as the gold standard for office blood pressure measurement, the widespread ban of use of mercury devices has diminished their role in hospital settings. Alternative methods such as automated electronic devices have gained increased popularity. The preferred location of measurement is the upper arm, but errors may occur because of changes in the position of the arm. Other technical sources of error include inappropriate cuff size and too
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A version of this article originally appeared in Cardiology Clinics volume 20, issue 2.
This work was supported by Grant No. R01HL078566 from the National Institutes of Health.
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