Top Things to Know: Measurement of Blood Pressure in Humans
Published: March 04, 2019
- It is estimated that about 46% of the US adult population have hypertension.
- Accurate measurement of blood pressure is critical for the diagnosis and management of hypertension.
- The purpose of this paper is to update the information presented in the 2005 Recommendations for Blood Pressure Measurement in Humans and Experimental Animals paper and to do a deep dive into the non-invasive modalities for measurement of blood pressure.
- This statement discusses blood pressure (BP) components, these are: systolic and diastolic measurement, pulse pressure, mid-blood pressure and mean arterial pressure for background on BP in humans.
- Guidance on blood pressure measurement in the healthcare provider setting is reviewed. Key components discussed are: determining cuff size and placement, stethoscope placement, the auscultatory technique (Korotkoff method), types of sphygmomanometers (mercury, aneroid, hybrids), oscillometric techniques, oscillometric devices, automated office BP (AOBP), measurements during the visit, and frequency of visits.
- Guidance for 24-hour ambulatory blood pressure monitoring include: medical staff or provider training, devices, cuffs and equipment used, patient preparation and instructions, frequency and the number of readings, and the analysis of the readings.
- An overview of home blood pressure monitoring (HBPM) procedures that should be used by medical staff are addressed: patient training provided by healthcare staff or providers, the preferred devices and cuffs, best practices for patients, the number of readings, the duration of monitoring and analyzing the readings. It is strongly suggested that patients measure their blood pressures outside of the doctor’s office in order to discover high blood pressure and with validated devices.
- The standard location for BP measurement is the upper arm, but alternative sites to measure BP include the wrist and fingers. Other modalities also employed are ultrasonography, tonometry, Smartphone technology as well as wearable sensors and cuffless BP monitors.
- Blood pressure measurement considerations are given for children, pregnancy, obese patients, older persons, pseudohypertension, patients with arrhythmias, pulseless syndromes, and patients with left ventricular assist devices.
- This statement provides clinicians and researchers a practical guide and a full compendium of information and resources to assist the clinical care of patients who are either at risk for or have hypertension.
Citation
Muntner P, Shimbo D, Carey RM, Charleston JB, Gaillard T, Misra S, Myers MG, Ogedegbe G, Schwartz JE, Townsend RR, Urbina EM, Viera AJ, White WB, Wright JT Jr; on behalf of the American Heart Association Council on Hypertension; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Clinical Cardiology; and Council on Quality of Care and Outcomes Research. Measurement of blood pressure in humans: a scientific statement from the American Heart Association. [published online ahead of print March 4, 2019]. Hypertension. 2019;71:e•••–e•••. DOI: 10.1161/HYP.0000000000000087.