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

Pickering, Thomas G.; Hall, John E.; Appel, Lawrence J.; Falkner, Bonita E.; Graves, John; Hill, Martha N.; Jones, Daniel W.; Kurtz, Theodore; Sheps, Sheldon G.; Roccella, Edward J.

doi:10.1161/01.hyp.0000150859.47929.8e

Cited by 2,051Blood Pressure and Hypertension StudiesNon-Invasive Vital Sign MonitoringCardiovascular Health and Disease Prevention

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

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Pickering, Thomas G., Hall, John E., Appel, Lawrence J., Falkner, Bonita E., Graves, John, Hill, Martha N., Jones, Daniel W., Kurtz, Theodore +2 more·2005·Hypertension

DOI 10.1161/01.hyp.0000150859.47929.8e

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Abstract

Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure–related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

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Many studies utilized 24-hour (or 48-hour) ambulatory blood pressure measurements, considered to be the most accurate method to diagnose hypertension and the best predictor of future cardiovascular risk.
“Many studies utilized 24-hour (or 48-hour) ambulatory BP measurements, considered to be the most accurate method to diagnose hypertension and the best predictor of future cardiovascular risk.154”
From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [154]
The Types of Monitor section (page not available) describes ambulatory monitoring as a research technique typically used for 24 hours. The Prognostic Significance section says ambulatory blood pressure predicts morbid events better than clinic blood pressure. It does not establish that 24- or 48-hour monitoring is the most accurate method for diagnosing hypertension or the best predictor among all methods; it notes that nighttime blood pressure may be the best predictor of risk. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Blood pressure was recorded at each visit as the mean of two or more measurements obtained using the recommended measurement guidelines from the American Heart Association.
“Blood pressure recorded at each visit was the mean of two or more BP measurements obtained using the recommended measurement guidelines from the American Heart Association [22].”
From Effectiveness of Digital Medicines to Improve Clinical Outcomes in Patients with Uncontrolled Hypertension and Type 2 Diabetes: Prospective, Open-Label, Cluster-Randomized Pilot Clinical Trial (2017) · cites this paper as [22]
Deviation from recommended protocols increases the likelihood of BP measurement error.
“As with best-practice measurement of BP under resting conditions, operators must follow a standardized protocol to measure exercise BP because deviation from recommended protocols will increase the likelihood of BP measurement error [49].”
From The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance (2022) · cites this paper as [49]

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Authors: Pickering, T. G., Hall, J. E., Appel, L. J., Falkner, B. E., Graves, J., Hill, M. N., Jones, D. W., Kurtz, T., Sheps, S. G., & Roccella, E. J.
ORCID: Pickering, Thomas G.
Hall, John E.
Appel, Lawrence J.
Falkner, Bonita E.
Jones, Daniel W.
Kurtz, Theodore
Venue: Hypertension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-01
Volume: 45
Issue: 1
Pages: 142-161
ISSN: 0194-911X (ISSN-L)
1524-4563
DOI: 10.1161/01.hyp.0000150859.47929.8e
OpenAlex: W2160801689
Semantic Scholar: cc608ac67b0966145e814f721be04e1b0f95eeb3
Cited by: 2,051
References: 226
Citations by year: 2026: 34 · 2025: 43 · 2024: 48 · 2023: 61 · 2022: 79 · 2021: 77 · 2020: 101 · 2019: 85 · 2018: 113 · 2017: 144 · 2016: 166 · 2015: 161 · 2014: 104 · 2013: 114 · 2012: 133
FWCI: 39.42
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Hypertension (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords: blood pressure measurement, auscultatory method, Korotkoff sounds, mercury sphygmomanometer, aneroid sphygmomanometer, oscillometric method, home blood pressure monitoring, ambulatory blood pressure monitoring, white coat hypertension, cuff size, observer training, pregnant women, laboratory animals, hypertension risk prediction
MeSH terms: Adult, Aged, Animals, Auscultation, Automation, Blood Pressure Determination, Calibration, Cardiovascular Diseases, Child, Circadian Rhythm, Clinical Competence, Diagnostic Errors, Equipment Design, Female, Humans, Hypertension, Male, Middle Aged, Obesity, Organ Specificity, Oscillometry, Posture, Predictive Value of Tests, Pregnancy, Self Care, Stress, Psychological, Blood Pressure Monitors, Blood Pressure Monitoring, Ambulatory

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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

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