AHA Updates BP Measurement Guidance

The American Heart Association has released an update to its 2005 statement on the measurement of blood pressure (BP).

The update comes in response to the development of semiautomated and automated oscillometric devices that provide more accurate measurements of BP than auscultation, as well as evidence suggesting a difference in BP measured in and outside of the office.

Among the highlights:

• In the office setting, oscillometric devices provide a method of BP measurement that could reduce the risk of human error associated with auscultatory measurement.
• Using a validated automated office BP (AOBP) device that can take and average 3 BP readings should be considered the preferred approach for evaluating office BP.
• Unattended AOBP may be preferred to ensure that the patient is not talking during measurement.
• Ambulatory BP measurement (ABPM) is the preferred method for out-of-office BP assessment, with the main indications being to detect white-coat hypertension and masked hypertension.
• Thigh cuffs may be used in patients with arm circumference exceeding the largest available arm cuff, and wrist measurement may be used in those for whom thigh cuffs are not large enough.

“[W]e cannot  overstate  the importance of using only validated devices, routinely calibrating and maintaining BP measurement devices, and having BP measured by healthcare providers who have been properly trained and retrained,” the writing committee concluded.

—Michael Potts

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.