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Blood pressure measurement: the problem and its solution

Journal of Human Hypertension volume 18, pages 757–759 (2004)Cite this article

In order to solve a problem, we need to realise that it exists, we need to appreciate its importance and we need a solution. This is only too evident to clinicians treating a symptomless risk factor like hypertension. The patient is generally unaware that there is a problem. Simply recognising that our patient has high blood pressure is not sufficient. We need him to understand that his high blood pressure has real consequences for his future health. Only then will he consider taking treatment.

Ironically, we are just beginning to appreciate the extent to which the measurement of blood pressure may itself be a problem. Matthys et al1 are the latest in a series of investigators to demonstrate and quantify some of the many factors affecting blood pressure measurement in the clinic. They find that the presence of a final-year medical student raises measured blood pressure by 4.8/1.7 mmHg. Others have drawn attention to widespread use of uncalibrated sphygmomanometers,2 zero-digit bias,3 the effects of taking blood tests,4 the influence of the rest period,5 cuff size,6 and a number of other factors on measured blood pressure.7 Attention has been drawn to the misclassification that results from measuring something as intrinsically variable as blood pressure.8

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  1. Department of Public Health & Epidemiology, University of Birmingham, Edgbaston, Birmingham, UK

    T Marshall

  2. Division of General Medicine & Primary Care, Brigham & Women's Hospital, Boston, MA, USA

    T Marshall

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Correspondence to T Marshall.

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Marshall, T. Blood pressure measurement: the problem and its solution. J Hum Hypertens 18, 757–759 (2004). https://doi.org/10.1038/sj.jhh.1001753

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