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Principles of Blood Pressure Measurement – Current Techniques, Office vs Ambulatory Blood Pressure Measurement.

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Hypertension: from basic research to clinical practice

Abstract

Blood pressure measurement has a long history and a crucial role in clinical medicine. Manual measurement using a mercury sphygmomanometer and a stethoscope remains the Gold Standard. However, this technique is technically demanding and commonly leads to faulty values. Automatic devices have helped to improve and simplify the technical aspects, but a standardised procedure of obtaining comparable measurements remains problematic and may therefore limit their validity in clinical practice. This underlines the importance of less error-prone measurement methods such as ambulatory or home blood pressure measurements and automated office blood pressure measurements. These techniques may help to uncover patients with otherwise unrecognised or overestimated arterial hypertension. Additionally these techniques may yield a better prognostic value.

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References

  1. O’Brien E, Fitzgerald D (1994) The history of blood pressure measurement. J Hum Hypertens 8(2):73–84

    PubMed  Google Scholar 

  2. Richardson DW, Honour AJ, Fenton GW, Stott FH, Pickering GW (1964) Variation in arterial pressure throughout the day and night. Clin Sci 26:445–460

    CAS  PubMed  Google Scholar 

  3. Bevan AT, Honour AJ, Stott FH (1969) Direct arterial pressure recording in unrestricted man. Br Heart J 31(3):387–388

    CAS  PubMed  Google Scholar 

  4. Hinman AT, Engel BT, Bickford AF (1962) Portable blood pressure recorder. Accuracy and preliminary use in evaluating intradaily variations in pressure. Am Heart J 63:663–668

    Article  CAS  PubMed  Google Scholar 

  5. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet Lond Engl 360(9349):1903–1913

    Article  Google Scholar 

  6. Pickering G (1972) Hypertension. Definitions, natural histories and consequences. Am J Med 52(5):570–583

    Article  CAS  PubMed  Google Scholar 

  7. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M et al (2013) 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 31(7):1281–1357

    Article  CAS  PubMed  Google Scholar 

  8. Collins R, MacMahon S (1994) Blood pressure, antihypertensive drug treatment and the risks of stroke and of coronary heart disease. Br Med Bull 50(2):272–298

    Article  CAS  PubMed  Google Scholar 

  9. Head GA, Mihailidou AS, Duggan KA, Beilin LJ, Berry N, Brown MA et al (2010) Definition of ambulatory blood pressure targets for diagnosis and treatment of hypertension in relation to clinic blood pressure: prospective cohort study. BMJ 340:c1104

    Article  PubMed  PubMed Central  Google Scholar 

  10. National Clinical Guideline Centre (UK) (2011) Hypertension: the clinical management of primary hypertension in adults: update of clinical guidelines 18 and 34 [Internet]. London: Royal College of Physicians (UK); [cited 2016 Feb 21]. (National Institute for Health and Clinical Excellence: Guidance). Available from: http://www.ncbi.nlm.nih.gov/books/NBK83274/

  11. Zeller A, Sigle J-P, Battegay E, Martina B (2005) Value of a standard urinary dipstick test for detecting microalbuminuria in patients with newly diagnosed hypertension. Swiss Med Wkly 135(3–4):57–61

    PubMed  Google Scholar 

  12. Piper MA, Evans CV, Burda BU, Margolis KL, O’Connor E, Whitlock EP (2015) Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 162(3):192–204

    Article  PubMed  Google Scholar 

  13. Lehmann MV, Zeymer U, Dechend R, Kaiser E, Hagedorn I, Deeg E et al (2013) Ambulatory blood pressure monitoring: is it mandatory for blood pressure control in treated hypertensive patients?: prospective observational study. Int J Cardiol 168(3):2255–2263

    Article  CAS  PubMed  Google Scholar 

  14. Hänninen M-RA, Niiranen TJ, Puukka PJ, Kesäniemi YA, Kähönen M, Jula AM (2013) Target organ damage and masked hypertension in the general population: the Finn-Home study. J Hypertens 31(6):1136–1143

    Article  PubMed  Google Scholar 

  15. Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG et al (2014) Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens Greenwich Conn 16(1):14–26

    Article  Google Scholar 

  16. Siu AL, U.S. Preventive Services Task Force (2015) Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 163(10):778–786

    Article  PubMed  Google Scholar 

  17. Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL (2012) Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet Lond Engl 379(9819):905–914

    Article  Google Scholar 

  18. Beevers G, Lip GY, O’Brien E (2001) ABC of hypertension. Blood pressure measurement. Part I-sphygmomanometry: factors common to all techniques. BMJ 322(7292):981–985

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Thulin T, Andersson G, Scherstén B (1975) Measurement of blood pressure--a routine test in need of standardization. Postgrad Med J 51(596):390–395

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN et al (2005) Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation 111(5):697–716

    Article  PubMed  Google Scholar 

  21. O’Brien E, Waeber B, Parati G, Staessen J, Myers MG (2001) Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 322(7285):531–536

    Article  PubMed  PubMed Central  Google Scholar 

  22. dabl Educational Trust – Table of recommended devices by category [Internet]. [cited 2016 Mar 26]. Available from: http://www.dableducational.org/sphygmomanometers/recommended_cat.html

  23. O’Brien E, Pickering T, Asmar R, Myers M, Parati G, Staessen J et al (2002) Working Group on Blood Pressure Monitoring of the European Society of Hypertension International Protocol for validation of blood pressure measuring devices in adults. Blood Press Monit 7(1):3–17

    Article  PubMed  Google Scholar 

  24. O’Brien E, Atkins N, Stergiou G, Karpettas N, Parati G, Asmar R et al (2010) European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit 15(1):23–38

    Article  PubMed  Google Scholar 

  25. Landgraf J, Wishner SH, Kloner RA (2010) Comparison of automated oscillometric versus auscultatory blood pressure measurement. Am J Cardiol 106(3):386–388

    Article  PubMed  Google Scholar 

  26. Kiers HD, Hofstra JM, Wetzels JFM (2008) Oscillometric blood pressure measurements: differences between measured and calculated mean arterial pressure. Neth J Med 66(11):474–479

    CAS  PubMed  Google Scholar 

  27. Parati G, Bilo G, Mancia G (2004) Blood pressure measurement in research and in clinical practice: recent evidence. Curr Opin Nephrol Hypertens 13(3):343–357

    Article  PubMed  Google Scholar 

  28. SPRINT Research Group, Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM et al (2015) A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 373(22):2103–2116

    Article  Google Scholar 

  29. Lonn EM, Bosch J, López-Jaramillo P, Zhu J, Liu L, Pais P et al (2016) Blood-Pressure Lowering in Intermediate-Risk Persons without Cardiovascular Disease. N Engl J Med 2

    Google Scholar 

  30. Niiranen TJ, Mäki J, Puukka P, Karanko H, Jula AM (2014) Office, home, and ambulatory blood pressures as predictors of cardiovascular risk. Hypertension 64(2):281–286

    Article  CAS  PubMed  Google Scholar 

  31. Myers MG, Godwin M, Dawes M, Kiss A, Tobe SW, Kaczorowski J (2012) Conventional versus automated measurement of blood pressure in the office (CAMBO) trial. Fam Pract 29(4):376–382

    Article  PubMed  Google Scholar 

  32. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y et al (2008) European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens 26(8):1505–1526

    Article  CAS  PubMed  Google Scholar 

  33. Sebo P, Pechère-Bertschi A, Herrmann FR, Haller DM, Bovier P (2014) Blood pressure measurements are unreliable to diagnose hypertension in primary care. J Hypertens 32(3):509–517

    Article  CAS  PubMed  Google Scholar 

  34. Holland M, Lewis PS (2014) An audit and suggested guidelines for in-patient blood pressure measurement. J Hypertens 32(11):2166–2170; discussion 2170

    Article  CAS  PubMed  Google Scholar 

  35. Mancia G, Bertinieri G, Grassi G, Parati G, Pomidossi G, Ferrari A et al (1983) Effects of blood-pressure measurement by the doctor on patient’s blood pressure and heart rate. Lancet Lond Engl 2(8352):695–698

    Article  CAS  Google Scholar 

  36. Ward AM, Takahashi O, Stevens R, Heneghan C (2012) Home measurement of blood pressure and cardiovascular disease: systematic review and meta-analysis of prospective studies. J Hypertens 30(3):449–456

    Article  CAS  PubMed  Google Scholar 

  37. O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G et al (2013) European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens 31(9):1731–1768

    Article  PubMed  Google Scholar 

  38. Parati G, Stergiou G, O’Brien E, Asmar R, Beilin L, Bilo G et al (2014) European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring. J Hypertens 32(7):1359–1366

    Article  CAS  PubMed  Google Scholar 

  39. Watson RD, Stallard TJ, Flinn RM, Littler WA (1980) Factors determining direct arterial pressure and its variability in hypertensive man. Hypertension 2(3):333–341

    Article  CAS  PubMed  Google Scholar 

  40. Littler WA, Honour AJ, Sleight P (1973) Direct arterial pressure and electrocardiogram during motor car driving. Br Med J 2(5861):273–277

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Littler WA, Honour AJ, Sleight P (1974) Direct arterial pressure, heart rate and electrocardiogram during human coitus. J Reprod Fertil 40(2):321–331

    Article  CAS  PubMed  Google Scholar 

  42. Dolan E, Stanton A, Thijs L, Hinedi K, Atkins N, McClory S et al (2005) Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 46(1):156–161

    Article  CAS  PubMed  Google Scholar 

  43. Hermida RC, Ayala DE, Mojón A, Fernández JR (2012) Sleep-time blood pressure and the prognostic value of isolated-office and masked hypertension. Am J Hypertens 25(3):297–305

    Article  PubMed  Google Scholar 

  44. Lovibond K, Jowett S, Barton P, Caulfield M, Heneghan C, Hobbs FDR et al (2011) Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study. Lancet Lond Engl 378(9798):1219–1230

    Article  Google Scholar 

  45. Palatini P, Mormino P, Canali C, Santonastaso M, De Venuto G, Zanata G et al (1994) Factors affecting ambulatory blood pressure reproducibility. Results of the HARVEST Trial. Hypertension and Ambulatory Recording Venetia Study. Hypertension 23(2):211–216

    Article  CAS  PubMed  Google Scholar 

  46. Sleight P (1985) Ambulatory blood pressure monitoring. Hypertension 7(2):163–164

    Article  CAS  PubMed  Google Scholar 

  47. Guelen I, Westerhof BE, van der Sar GL, van Montfrans GA, Kiemeneij F, Wesseling KH et al (2008) Validation of brachial artery pressure reconstruction from finger arterial pressure. J Hypertens 26(7):1321–1327

    Article  CAS  PubMed  Google Scholar 

  48. Silke B, McAuley D (1998) Accuracy and precision of blood pressure determination with the Finapres: an overview using re-sampling statistics. J Hum Hypertens 12(6):403–409

    Article  CAS  PubMed  Google Scholar 

  49. Schutte AE, Huisman HW, van Rooyen JM, Malan NT, Schutte R (2004) Validation of the Finometer device for measurement of blood pressure in black women. J Hum Hypertens 18(2):79–84

    Article  CAS  PubMed  Google Scholar 

  50. Gesche H, Grosskurth D, Küchler G, Patzak A (2012) Continuous blood pressure measurement by using the pulse transit time: comparison to a cuff-based method. Eur J Appl Physiol 112(1):309–315

    Article  PubMed  Google Scholar 

  51. Bilo G, Zorzi C, Ochoa Munera JE, Torlasco C, Giuli V, Parati G (2015) Validation of the Somnotouch-NIBP noninvasive continuous blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Blood Press Monit 20(5):291–294

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Annina S. Vischer .

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Vischer, A.S., Burkard, T. (2016). Principles of Blood Pressure Measurement – Current Techniques, Office vs Ambulatory Blood Pressure Measurement.. In: Islam, M.S. (eds) Hypertension: from basic research to clinical practice. Advances in Experimental Medicine and Biology(), vol 956. Springer, Cham. https://doi.org/10.1007/5584_2016_49

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  • DOI: https://doi.org/10.1007/5584_2016_49

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44250-1

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