Advances in techniques to measure BP accurately are essential outside and in the office setting, according to a scientific statement published by the American Heart Association in Hypertension.
The mission of the statement, according to Paul Muntner, PhD, MHS, FAHA, the chair of the writing committee, and colleagues, was to update findings previously released in the 2005 AHA scientific statement on measurement of BP in humans.
“Many oscillometric devices, which use an electronic pressure sensor within the blood pressure cuff, have been validated (checked for accuracy) which allow for accurate blood pressure measurement in the health care office settings while reducing human errors associated with the auscultatory approach,” Muntner, a professor of epidemiology at the University of Alabama at Birmingham, said in a press release.
New practices for in-office BP measurement
Use an appropriately sized cuff was recommended by the panel to accurately measure office BP.
A calibrated aneroid or hybrid sphygmomanometer was determined to be a reliable and safer method of measuring BP in-office compared with a mercury sphygmomanometer, Muntner and colleagues wrote.
Employing oscillometric devices that can provide multiple readings in a single use has become a more effective means to making practices such as automated office BP possible.
Out-of-office BP measurements
Muntner and colleagues recommended the use of ambulatory BP monitoring as a recommended technique to confirm hypertension diagnosis outside the office, with home BP monitoring considered an alternative when ambulatory BP monitoring is unavailable.
Utilization of ambulatory BP monitoring can identify BP patterns not diagnosed with in-office BP monitoring such as white-coat, masked and nocturnal hypertension, the panel wrote.
High nighttime BP on ambulatory BP monitoring is associated with increased CVD risk, the panel wrote.
In adolescents and children, use of oscillometric and auscultatory measurements for BP were considered an acceptable standard, Muntner and colleagues wrote.
In a video commentary provided by the AHA, Muntner said the key take-home message from the scientific statement is the importance of measuring BP outside of the doctor’s office.
“Although it’s been long known that many people get nervous when they go to their doctor and have white-coat hypertension, something new over the past 15 years is that many people who have normal blood pressure when measured in their doctor’s office have high blood pressure outside their doctor’s office,” Muntner said. “Therefore, it’s important that people get their BP measured correctly so that they can have hypertension diagnosed and if they’ll benefit from treatment that they get started on blood pressure-lowering medications.”.
