Blood pressure measurement in the diagnosis and management of hypertension in adults
- Norman M Kaplan, MD
Norman M Kaplan, MD
- Editor-in-Chief — Nephrology
- Section Editor — Hypertension
- Clinical Professor of Internal Medicine
- University of Texas Southwestern Medical Center
- 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
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".)
METHODS FOR THE DIAGNOSIS OF HYPERTENSION
Hypertension can be diagnosed using one of the following three acceptable measurement strategies:
●Ambulatory blood pressure monitoring (ABPM)
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- METHODS FOR THE DIAGNOSIS OF HYPERTENSION
- AMBULATORY BLOOD PRESSURE MONITORING
- HOME BLOOD PRESSURE MONITORING
- Cuff inflation hypertension
- OFFICE-BASED BLOOD PRESSURE MEASUREMENT
- Time of measurement
- Type of measurement device
- - Automated oscillometric BP measurement
- 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
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS