Blood pressure measurement in the diagnosis and management of hypertension in adults
- George Thomas, MD, MPH, FACP, FASN
George Thomas, MD, MPH, FACP, FASN
- Director, Center for Blood Pressure Disorders, Cleveland Clinic
- Assistant Professor, Cleveland Clinic Lerner College of Medicine
- Marc A Pohl, MD
Marc A Pohl, MD
- Ray W. Gifford, Jr., MD Endowed Chair in Hypertension
- Nephrology and Hypertension
- Cleveland Clinic
- Section Editor
- George L Bakris, MD
George L Bakris, MD
- Editor-in-Chief — Nephrology
- Section Editor — Hypertension
- Professor of Medicine
- The University of Chicago
- Deputy Editors
- Daniel J Sullivan, MD, MPH
Daniel J Sullivan, MD, MPH
- Deputy Editor — Primary Care (Adult)
- Assistant Professor of Medicine
- Harvard Medical School
- John P Forman, MD, MSc
John P Forman, MD, MSc
- Senior Deputy Editor — UpToDate
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
Correct measurement and interpretation of the blood pressure (BP) is essential in the diagnosis and management of hypertension. It is essential that BP machines are properly calibrated, appropriate cuff sizes are selected, and, when BP is measured in an office-based setting, personnel are properly trained and the patient is positioned correctly.
BP measurement in the diagnosis and management of hypertension, including the technique required for office-based measurements, will be reviewed here. Detailed descriptions of ambulatory and home-based BP monitoring are presented elsewhere. (See "Ambulatory and home blood pressure monitoring and white coat hypertension in adults".)
An overview of hypertension in adults and discussions pertaining to patient selection for antihypertensive therapy, choice of antihypertensive therapy, and management of older adults with isolated systolic hypertension can be found in other topics. (See "Overview of hypertension in adults" and "Hypertension: Who should be treated?" and "Choice of drug therapy in primary (essential) hypertension" and "Treatment of hypertension in the elderly patient, particularly isolated systolic hypertension".)
OUR APPROACH TO MEASURING BLOOD PRESSURE
Selecting a measurement strategy — Blood pressure (BP) can be measured using one of the following three acceptable strategies:
●Ambulatory blood pressure monitoring (ABPM)
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- OUR APPROACH TO MEASURING BLOOD PRESSURE
- Selecting a measurement strategy
- Interpretation of blood pressure measurements
- PRACTICAL AND TECHNICAL ASPECTS OF MEASUREMENT STRATEGIES
- Ambulatory blood pressure monitoring
- Home blood pressure monitoring
- - Cuff inflation hypertension
- Office-based blood pressure measurement
- - Routine office-based blood pressure
- Time of measurement
- Type of measurement devices
- Cuff size
- - Pseudohypertension
- Patient position
- Cuff placement
- Technique of measurement
- - Auscultatory method of measurement
- - Oscillometric method of measurement
- Need for multiple measurements
- Alternative sites for measurement
- - Leg blood pressure
- - Wrist blood pressure
- - Automated oscillometric blood pressure measurement
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS