Recommendations
for Blood Pressure Measurement
in Humans and Experimental Animals Hypertension.
2005;45:142.
Part
1: Blood Pressure Measurement in Humans: A Statement for Professionals From the
Subcommittee of Professional and Public Education of the American Heart Association
Council on High Blood Pressure Research Thomas
G. Pickering, MD, DPhil; John E. Hall, PhD; Lawrence J. Appel, MD; Bonita E. Falkner,
MD; John Graves, MD; Martha N. Hill, RN, PhD; Daniel W. Jones, MD; Theodore Kurtz,
MD; Sheldon G. Sheps, MD; Edward J. Roccella, PhD, MPH
Abstract Accurate
measurement of blood pressure is essential to classify individuals, to ascertain
blood pressure–related risk, and to guide management. The auscultatory technique
with a trained observer and mercury sphygmomanometer continues to be the method
of choice for measurement in the office, using the first and fifth phases of the
Korotkoff sounds, including in pregnant women. The use of mercury is declining,
and alternatives are needed. Aneroid devices are suitable, but they require frequent
calibration. Hybrid devices that use electronic transducers instead of mercury
have promise. The oscillometric method can be used for office measurement, but
only devices independently validated according to standard protocols should be
used, and individual calibration is recommended. They have the advantage of being
able to take multiple measurements. Proper training of observers, positioning
of the patient, and selection of cuff size are all essential. It is increasingly
recognized that office measurements correlate poorly with blood pressure measured
in other settings, and that they can be supplemented by self-measured readings
taken with validated devices at home. There is increasing evidence that home readings
predict cardiovascular events and are particularly useful for monitoring the effects
of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction
of risk than office measurements and is useful for diagnosing white-coat hypertension.
There is increasing evidence that a failure of blood pressure to fall during the
night may be associated with increased risk. In obese patients and children, the
use of an appropriate cuff size is of paramount importance. Full
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SUSCRIBASE 
