Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Abstract

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. (Circulation. 2005;111:697-716.)

Prognostic Utility of Morning Blood Pressure Surge for 20‐Year All‐Cause and Cardiovascular Mortalities: Results of a Community‐Based Study

“…Although BP measurement every 15 to 30 minutes during asleep hours for ABPM was formally recommended in 2005,25 the adequacy has never been scientifically proved. In our simulation studies, we have demonstrated clearly that rate of STMS is less susceptible to measurement error than the amplitude by involving more BP measurements within the time frame between the nighttime trough and morning.…”

Heritability of Ambulatory and Beat-to-Beat Office Blood Pressure in Large Multigenerational Arab Pedigrees: The ‘Oman Family Study’

“…A more detailed description of the cohort stratification and the OFS design can be found in earlier reports (Bochud et al, 2005). Hypertension was diagnosed when subjects had a 24-hour SBP and/or DBP ≥135/85 mmHg (Pickering et al, 2005) or when they were on antihypertensive treatment. The prevalence of hypertension was 20% (males 22% and females 18%) with 2% of both genders on medication.…”

Protocol for a cluster randomised controlled trial on information technology-enabled nutrition intervention among urban adults in Chandigarh (India): SMART eating trial

“…Weight will be measured with minimum clothing without shoes to the nearest 0.1 kg on a portable electronic weighing scale. Blood pressure will be measured twice using a standard instrument to the nearest 2 mm Hg [35]. Blood samples (5 mL: 1 mL-EDTA vial, 1 mL-Oxalate vial and 3 mL-plain vial) will be obtained to estimate haemoglobin, plasma glucose (mg/dL), total serum cholesterol (mg/dL), high-density lipoprotein (mg/dL), low-density lipoprotein (mg/dL) and triglycerides (mg/dL) using standard laboratory methods.…”