Recommendations for Blood Pressure

Recommendations for Blood Pressure Measurement inHumans and Experimental AnimalsPart 1: Blood Pressure Measurement in HumansA Statement for Professionals From the Subcommittee of Professional andPublic Education of the American Heart Association Council onHigh Blood Pressure ResearchThomas 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, MPHAbstract—Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure–relatedrisk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometercontinues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoffsounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices aresuitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury havepromise. The oscillometric method can be used for office measurement, but only devices independently validatedaccording to standard protocols should be used, and individual calibration is recommended. They have the advantageof being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection ofcuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressuremeasured in other settings, and that they can be supplemented by self-measured readings taken with validated devicesat home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful formonitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than officemeasurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of bloodpressure to fall during the night may be associated with increased risk. In obese patients and children, the use of anappropriate cuff size is of paramount importance. (Hypertension. 2005;45:142-161.)

Recommendations for Blood Pressure Measurement in
Humans and Experimental Animals
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 Guide to Management. The Auscultatory Technique with a trained Observer and Mercury sphygmomanometer
Continues to be the method for measurement of Choice 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. Devices that use hybrid Electronic transducers instead of Mercury have
Promise. Can be used for the method oscillometric measurement Office, but only independently Devices Validated
according to standard protocols should be used, and individual Calibration is Recommended. They have the Advantage
of being Able to take multiple measurements. Training of observers proper, Positioning of the Patient, and selection of
cuff Size are all Essential. It is increasingly recognized that correlate poorly with blood pressure measurements Office
measured in Other settings, and that they Can be supplemented by self-measured readings taken with Validated Devices
at Home. Evidence that there is increasing predict cardiovascular events and Home readings 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. Evidence that there is a Failure of increasing blood
pressure during the Night May Fall to be associated with Increased risk. Patients in obese and Children, the use of an
appropriate cuff Size is of Paramount importance. (Hypertension. 2005; 45: 142-161.).

Recommendations for Blood Pressure Measurement in
Humans and Experimental Animals
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. (Hypertension.? 2005; 45:142-161.).