AHA Issues Scientific Statement on Accurate Blood Pressure Readings

• BP measurements in other settings
  • Measurements conducted by trained pharmacists may be an alternative to HBPM
  • Kiosks used to measure BP often do not have cuffs that fit large arms

• BP measurement ins pecial populations
  • Children
    • Oscillometric and auscultatory methods are both acceptable for screening BP measurements
    • BP should betaken in the right arm
  • Pregnant patients
    • BP measurement devices need to be validated among pregnant women due to the hemodynamic and vascular changes that occur
    • A systematic review has reported devices that have been validated for pregnant women
  • Obese patients
    • Tronco-conical shaped BP cuffs may be useful.
    • If a patient’s arm circumference exceeds the largest arm cuff available, a thigh cuff can be used
    • If a thigh cuff does not fit, BP can be measured at the wrist.
  • Older adults
    • Sitting and standing BP measurements can identify orthostatic hypotension
    • ABPM may identify white-coat hypertension, hypotension in the postprandial state and after awakening in the morning

• BP variability
  • Short-term BP variability has low reproducibility and is not associated with risk for CVD events
  • Visit-to-visit variability is associated with risk for CVD events
  • Calcium channel blockers and thiazide-type diuretics are associated with lower visit-to-visit variability of BP

“Regardless of the method used to measure BP, initial and ongoing training of technicians and healthcare providers and the use of validated and calibrated devices are critical for obtaining accurate BP measurements,” the researchers wrote.

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Reference

Muntner P, Shimbo D, Carey RM, et al. Measurement of blood pressure in humans: a scientific statement from the American Heart Association [published online March 4, 2019]. Hypertension. doi:10.1161/HYP.0000000000000087

This article originally appeared on The Cardiology Advisor