Human blood pressure determination by sphygmomanometry.

Abstract

Association's recommendations for indirect measurement of arterial blood pressure.The purpose is to facilitate the AHA's mission to reduce disability and death from cardiovascular diseases and stroke by providing practical guidelines for measuring an important physiological variable that contributes to and is associated with these major diseases.The recom- mendations are intended to provide a uniform standard and methodology for day-to-day use by all health care workers and for use in epidemiological, educational, and clinical studies.This edition clarifies and updates information provided in previous versions.The writing group is indebted to the previous groups and their chairmen for their extensive work and expresses special appreciation to the late Dr. Walter Kirkendall for his lifelong work in the field of hypertension.Arterial blood pressure, one of the "vital signs," is an important indicator of a person's state of health; there- fore, its measurement is a part of every complete physical examination.Blood pressure measurement is done to screen for hypertension, to assess a person's suitability for certain occupations and activities, to estimate long-term cardiovascular risk, to determine eligibility for insurance, and as a part of the manage- ment of patients with many types of medical problems.Inappropriately low blood pressure, or clinical shock, is a medical emergency, and inappropriately high blood pressure is a marker for the chronic condition hypertension, which is a major risk factor for premature cardiovascular, cerebrovascular, renovascular, and other vascular diseases.The gold standard for measurement of arterial pres- sure is direct intra-arterial measurement with a catheter.However, this technique is neither practical nor appropriate for repeated measurements in nonhospitalized patients or asymptomatic individuals, nor for large- scale public health screenings.Instead, the indirect method of measurement is commonly used.With this technique the pressure required to collapse the artery in the upper arm or leg is determined by use of a sphygmomanometer (an occluding cuff, stethoscope, and ma- nometer).The cuff is inflated to a level above arterial pressure (as indicated by obliteration of the pulse).