High Blood Pressure / Hypertension

Monitoring of Blood Pressure: Measurement of Blood Pressure

By Cardiologist on January 28th, 2010

Blood pressure can be monitored at the healthcare practitioner’s office (or clinic) with a standard sphygmomanometer, throughout the day and night with a 24-hour ambulatory blood pressure monitor, or at home with a self-monitoring device.

Office

The clinical standard for measurement of blood pressure for diagnostic and treatment purposes has long been office measurement. A diagnosis of hypertension can be made based on the average of two or more readings taken at each of two or more visits after an initial screening. These blood pressures should be taken preferably with a mercury sphygmomanometer; otherwise, a recently calibrated aneroid manometer or a validated digital device can be used. Office blood pressure values were used in the studies showing the relationship between blood pressure and cardiovascular disease risk and in the clinical trials documenting the efficacy of antihypertensive drug therapy.

Ambulatory

Twenty-four hour ambulatory blood pressure monitoring allows for automatic BP measurements at frequent intervals throughout the day and night. The patient is connected to a lightweight console that is linked to a cuff on the non-dominant arm. Ambulatory monitoring is most commonly used in patients with suspected white-coat hypertension. It is also helpful in patients with apparent drug resistance, hypotensive symptoms with antihypertensive therapy, episodic hypertension, and autonomic dysfunction. Ambulatory blood pressure monitoring is more costly than home blood pressure monitoring.

Home Monitoring (Self-Measurement)

The types of monitors available for home blood pressure measurement include mercury sphygmomanometers, aneroid manometers, and semiautomatic manual-inflation or automatic-inflation digital devices. Home blood pressure monitors vary in their accuracy, ease of use, and cost. Digital monitors with automatic cuff inflation are the most popular. According to IRI data, about 65% of the home blood pressure monitors in the U.S. are sold by Omron Healthcare under its brand name and private labels. Other distributors of home blood pressure monitors include A&D, Forecare, Health Team, Lumiscope, Panasonic, Mabis Healthcare, Mark of Fitness, Samsung, and Sunbeam.

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