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.

Development and validation of a blinded hybrid device according to the European Hypertension Society protocol: Nissei DM-3000

“…1 However, not surprisingly, the deflation rate of 2.5 mm s À1 was found to be most accurate for SBP, as it has previously been shown that faster deflation rates are likely to underestimate SBP. 19 One possible advantage in selecting a different deflation rate relates to the suggestion that measurement accuracy at a set deflation rate is influenced by heart rate.…”

“…The automated mode provides an alternative to auscultation when Korotkoff sounds are poor and eliminates terminal digital preference and observer bias, as well as the error incurred with rapid manual deflation rates. 1 However, as severe accuracy limitations have been shown with oscillometric BP Validation of Nissei DM-3000measurement in certain sub-populations, 5-8 these participants would benefit from the manual measurement mode of this device. The blinded measurement mode is a feature of devices such as the PMS Mandhaus 14 and A&D UM-101, 12 and although it has been reported to underestimate BP, we recognized the clinical benefit that such a measurement mode could offer.…”

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

“…Resting systolic (SBP) and diastolic (DBP) blood pressure were assessed in the population study using a hospital‐grade automated blood pressure monitor using a standard protocol (Omron 5 Series Upper Arm [BP742]) 30. Participants were sitting, legs uncrossed, with arms not restricted by clothing and relaxed, for at least 5 minutes before measurements were taken.…”

Relationship between a range of sedentary behaviours and blood pressure during early adolescence

“…We followed general recommendations on selecting cuff size to ensure that the bladder length was B80% and width was X40% of the arm circumference, covering the upper arm without obscuring the antecubital fossa. 21 Three separate BP measurements were taken, and averaged for analysis. Mean arterial BP (MABP) was calculated as one-third of the systolic plus two-thirds of the diastolic BP.…”