Requirements for professional office blood pressure monitors

For more than half a century measurement of blood pressure in the doctor's office using a mercury sphygmomanometer and the auscultatory method has been the cornerstone for hypertension management. However, due to the environmental and service issues mercury devices will not be available in the near future. As the mercury sphygmomanometer is being progressively eliminated from clinical use, it is being replaced by a variety of devices, which may not have been validated. This change in the practice of measurement may have an unpredictable impact on the threshold levels used for the diagnosis of hypertension and may also influence the management of hypertension. This expert document provides (i) information on the current availability of technologies and devices with potential for professional use (oscillometric, hybrid, aneroid and mercury devices) and the advantages and limitations of each one of them, and (ii) guidance on the requirements and selection of mercury-free blood pressure monitors for professional use. With the increasing use of automated oscillometric devices it is likely that the auscultatory technique will soon become redundant. However, consideration will be given to some of the technical aspects of the oscillometric technique and to the educational aspects of auscultation that may make it premature to abandon the technique altogether.