Blood pressure measurement

Cardiovascular diseases account for over half of all deaths in industrialized societies, and hypertension is one of the most treatable and preventable risk factors underlying that impressive statistic. Implicit in population and community control programs for high blood pressure is the recognition, evaluation and treatment of patients with elevated arterial pressures. The indirect measurement of arterial pressure has been available only within the past century, and the definition of procedures and techniques for its widespread use have been introduced only within the past few decades. The development of guidelines and recommendations for sphygmomanometry has been aided by epidemiological criteria and national hypertension programs worldwide. These guidelines have permitted identification of large numbers of patients with hypertension. Implicit in the screening of populations is the necessity to confirm the elevated arterial pressure on at least three separate occasions before diagnosis and treatment are instituted (unless the clinician deems that a hypertensive urgency or emergency exists). A number of pitfalls and practical considerations are discussed, and pertinent references to currently published guidelines are presented.