Professional Documents
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n this issue of The Journal of Clinical Hypertension, Pickering et al.1 summarize the American
Heart Association (AHA) Recommendations from
the Council of High Blood Pressure Research for
blood pressure (BP) measurements in humans. This
is an expanded and excellent update of the 1985
National High Blood Pressure Education Program
recommendations for medical devices for measuring BP and the AHA recommendations in 1993.2,3
The report is a must-read for anyone involved in
screening, treatment programs, or research that
involve BP measurements. There are, however, certain questions that practitioners may have about
its content.
For years, concerns have been expressed about
problems with the usual methods of recording
casual BPsproblems that may result in misdiagnoses and occasional inappropriate treatment.
The report appropriately notes that physicians
(and other health care providers) traditionally
round out the mm Hg numbers favoring a 5
and 0 rather than recording more exact readings. The AHA recommendations state that the
number should be more carefully determined and
recorded to the nearest 2 mm Hg. It is important
to note, however, that while scientifically this is an
important and correct recommendation, especially
in research studies, this is difficult to do in the real
world of practice. Determining specific numbers,
i.e., 2, 4, 6, 8, etc. on the BP monitor is difficult
and involves very careful attention with the current method of using a stethoscope and mercury
sphygmomanometer.
The recommendations note that the bell portion
of the stethoscope, rather than the diaphragm, be
used in taking BP. This is to be desired since there
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The Journal of Clinical Hypertension (ISSN 1524-6175) is published monthly by Le Jacq Ltd., Three Parklands Drive, Darien, CT 06820-3652. Copyright 2005 by Le Jacq Ltd., All rights reserved. No part of this publication may be
reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publishers. The opinions
and ideas expressed in this publication are those of the authors and do not necessarily reflect those of the Editors or Publisher. For copies in excess of 25 or for commercial purposes, please contact Sarah Howell at
showell@lejacq.com or 203.656.1711 x106.
72
REFERENCES
1 Pickering TG, Hall JE, Appel LJ, et al. Recommendations
for blood pressure management in humans: an AHA scientific statement from the Council on High Blood Pressure
Research Professional and Public Education Subcommittee.
J Clin Hypertens (Greenwich). 2005;7:102109.
2 Hunt J, Frohlich E, Moser M, et al. Devices used for selfmeasurement of blood pressure: revised statement of the
National High Blood Pressure Education Program. Arch
Intern Med. 1985;145:22312234.
3 Perloff D, Grim C, Flack J, et al. Human blood pressure determination by sphygmomanometry. Circulation.
1993;88:24602470.
The Journal of Clinical Hypertension (ISSN 1524-6175) is published monthly by Le Jacq Ltd., Three Parklands Drive, Darien, CT 06820-3652. Copyright 2005 by Le Jacq Ltd., All rights reserved. No part of this publication may be
reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publishers. The opinions
and ideas expressed in this publication are those of the authors and do not necessarily reflect those of the Editors or Publisher. For copies in excess of 25 or for commercial purposes, please contact Sarah Howell at
showell@lejacq.com or 203.656.1711 x106.