Blood pressure measurement and the guidelines: a proposed new algorithm for the diagnosis of hypertension

Current hypertension guidelines continue to base management decisions on the office BP as recorded by mercury sphygmomanometry. The imminent disappearance of mercury from the workplace for environmental and safety reasons provides an opportunity to re-assess how a diagnosis of hypertension is made. There are now several validated, automated BP recording devices available to replace mercury sphygmomanometers in the office setting. Self/home and 24-hour ambulatory BP monitoring should now become an integral part of the diagnostic algorithm for hypertension in view of their superior ability to predict clinical outcomes when compared to traditional office BP measurements.