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Accurate measurement of arterial pressure

Journal of Human Hypertension volume 17, pages 445–447 (2003)Cite this article

‘If only cardiologists did properly measure blood pressure’. Such a statement could be passed off as a gratuitous insult if it were not the title of a peer-reviewed article in a prestigious cardiological journal by three highly respected clinical, instrumental and epidemiological authorities.1 Messerli et al1 pressed the case by referring to recent clinical trials where definite benefit did not correspond to clinic recordings of arterial pressure, but often did to 24 h or nocturnal recordings. They also quoted another authority2 and his statement that ‘The measurement of blood pressure is likely the clinical procedure of greatest importance that is performed in the sloppiest manner.’ Messerli et al1 also referred to a 1990 survey3 on recommendations for blood pressure recordings from the American Heart Association (AHA), which found that not one of 114 participating cardiologists followed all the techniques for office blood pressure recording from the AHA. They endorsed Kaplan's view2 on ‘sloppiness’.

Why has this situation arisen? Kaplan2 and Messerli et al1 suggested that cardiologists have been more concerned with other, apparently more important measures, despite the fact that numerous studies have confirmed the prognostic value of properly determined office blood pressure.4 Yet one such measure (left ventricular ejection fraction) had up until 10 years ago been considered a vital piece of information in the diagnosis of cardiac failure — and now it is not.5 Is it just that blood pressure measurement is apparently so simple that it can be performed in the referring doctor's office or even by the patient at home, so that it does not warrant anything but passing attention by the ultimate authority? This authority, almost without exception, when using the auscultatory method, records values to the nearest 10 mmHg.

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  1. St Vincent's Clinic, University of New South Wales, Sydney, Australia

    Michael O'Rourke

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  1. Michael O'Rourke
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Correspondence to Michael O'Rourke.

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O'Rourke, M. Accurate measurement of arterial pressure. J Hum Hypertens 17, 445–447 (2003). https://doi.org/10.1038/sj.jhh.1001574

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