Advice from the BP Measurement Experts
At the recent 25th annual scientific meeting for the American Society of Hypertension, there was a new program track targeted specifically to clinicians in primary care. The aim was to present the latest hypertension strategies and guidelines in a format that would be appropriate for the primary care physician but also for physician's assistants, nurse practitioners as well as seasoned hypertension specialists. While the session covered various current issues related to hypertension, one clear area of attention was a re-focus on blood pressure measurement methods.
While accurate and appropriate blood pressure measurement is often considered a given in most clinical settings, proper technique is often an afterthought. According to ASH committee member F. Wilford Germino MD, "The majority of blood pressures done in this country and throughout the world are done incorrectly and not according to guidelines."1 Some of the more common errors discussed were improper cuff size selection, improper cuff application, failure to allow the patient to relax for at least 5 minutes prior to a BP measurement and too rapid deflation of the cuff during a manual auscultatory measurement.
There was much discussion about the benefits of standardizing on automated monitors for the measurement of blood pressure in the clinic in an effort to minimize the impact of improper technique during a manual measurement. While many of the experts on the session panel agreed there are benefits to standardizing on automated monitors in clinical practice, there were two cautioning points they emphasized. One is ensuring any automated monitor has been clinically validated to international standards such as the AAMI SP10 or BHS protocols. The second was always having the ability to verify the accuracy of an automated BP device by also providing means for taking a manual auscultatory blood pressure measurement.
To learn more about proper blood pressure measurement techniques and potential sources of error, be sure to check out our ebook and 10 Factors That Can Affect Blood Pressure Readings.
1 ASH Times, American Society of Hypertension: May 2, 2010.