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Advice from the BP Measurement Experts

How to Measure Blood Pressure [Infographic]

 

How to Measure BP Infographic Thumbnail

Whether you take blood pressure readings on a regular basis or you’re taking a BP measurement for the first time, it's always good to review the latest standards on how to measure blood pressure. You may think that you're using the correct method however, incorrect results caused by improper technique are more common than you might think. Follow the steps in the infographic below to ensure you get an accurate blood pressure reading every time. Use it as a quick review to sharpen your skills or check out our video for a step-by-step “how to” with more in-depth instruction.

 

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Errors in Manual BP Readings make Automated the Way to Go!

Manual Sphygmomanometer and Cuff

So for the last 100+ years, clinicians have been using the auscultatory method for determining a patient’s blood pressure. This method is used every day to determine if a patient needs medication or some other clinical intervention for high blood pressure. Performed correctly, it’s considered by many in the profession to be the ‘gold standard’ for measuring blood pressure. But it’s that phrase ‘performed correctly’ that’s the kicker.

A recent policy statement from the World Hypertension League calls into question the accuracy of many auscultatory BP measurements taken today. Huh? If it’s worked for over one hundred years, how is it possible that auscultatory measurements are now being deemed inaccurate?

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Blood Pressure Measurement Technique— A Candid Discussion

Audio Series by SunTech MedicalLet’s be clear. I work for the marketing department of a medical device manufacturer, so I earn my paycheck by promoting this company and its products to the clinical community and developing new products that we can successfully convert into $$$. But is it possible to achieve these goals as well as actually helping people to get and stay healthy? Let me put it this way—if it weren’t, I’d quit.

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Should Manual BP Get the Boot

Manual BP MeasurementThere's a bit of a debate going on in October's issue of the Journal of Hypertension about the best way to measure blood pressure. Everyone agrees that it should be done using a cuff placed over the brachial artery, but the similarities sort of end there.

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Has My Physician Measured My BP in Both Arms?

Doctor taking a BP measurementThat’s the question I pondered while reading an article published earlier this year in the American Journal of Hypertension. In the article “Blood Pressure Measurement Method and Inter-Arm Difference: A Meta-Analysis,"* the authors reviewed studies where BP was measured in both the left and right arm of subjects. The results showed that on average, Systolic pressures differ by 5.4 mmHg between arms while Diastolic pressures showed an average inter-arm difference of 3.6 mmHg.

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Korotkoff Sounds vs. Oscillometric BP Measurement

sphygmomanometerOne thing we like to do at the SunTech blog is share debates and comparisons of automated vs. manual auscultatory blood pressure measurements. The latest comes from an article published in the Journal of the American Society of Hypertension earlier this year. This evaluation compared one particular automated oscillometric device with the results from the auscultatory method of listening for Korotkoff sounds during cuff deflation. The authors’ aim was to help readers better understand the fundamental differences between these two methods and illustrate how that might assist clinicians in effectively controlling and managing hypertensive patients.


Understanding that there is a dramatic difference between these two methods is, in fact, an important consideration of which clinicians should be aware. The auscultatory method has been the standard method of determining BP for over 100 years and relies on the observer to detect the audible sounds (Korotkoff sounds) that occur during constricted blood flow. The oscillometric method, employed by most clinical-grade automated BP devices, analyzes pulse waves collected from the cuff during constricted blood flow. In this case, the cuff is the sensor. The auscultatory and oscillometric methods are two very different approaches to determining the same vital sign.

Each method also presents its own unique set of challenges. The manual auscultatory method is prone to poor technique, observer digit bias and poor hearing (often unbeknownst to the observer). The oscillometric method can be prone to errors when there is too much patient arm movement.  In addition, each medical device manufacturer uses their own proprietary algorithm for acquiring blood pressure measurements so BP readings may vary significantly between devices which makes it important to shop around for a clinical grade device that is validated to industry standards such as the AAMI SP10 protocol.

Being aware of these differences and limitations can certainly be of help to clinicians when making hypertension treatment decisions. For further information on some of the challenges and best practices when taking an auscultatory blood pressure measurement, be sure to check out our e-book “10 Steps to Accurate Blood Pressure Measurement”. We also invite you to share your comments and experiences when comparing automated and manual BP measurements.

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Automated BP vs Manual BP Measurement: Which is Better? (Part 2 of 2)

Doctor, nurse, and patientIn my last post, I discussed the importance of informed debate in helping determine effective clinical practice. Specifically, I mentioned two recent journal articles about automated oscillometric blood pressure devices that arrived at two different conclusions. In that post I also provided some comments from the SunTech perspective. Today, I’ll share the perspectives of an experienced, practicing physician on the subject of automated BP devices versus manual sphygmomanometers.

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Automated BP vs Manual BP Measurement: Which is Better? (Part 1 of 2)

Automated or manual BP debateWhat’s a clinician to do? Debates about clinical trials, patient populations, and statistical analyses can seem hollow and distant when looking at an anxious patient in an exam room. At that moment, all that matters is what’s best for your patient. Yet clinically relevant data, and more importantly, rigorous discussion of that data, is the means to the end. Professional clinicians quite often need the former in order to effectively deliver the latter. To wit, two similar journal articles were recently published that arrived at two very different conclusions. Let’s take a look:

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Instrument Calibration Adds Error Potential in Manual BP Measurement

Blood pressure instrumentsIn previous posts, we have reviewed the 10 Steps to Accurate Manual Blood Pressure Measurement and 10 Factors That Can Affect Blood Pressure Readings.  As important as these details are, accurate measurement also requires two things:

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Blood Pressure Fluctuations: 'Warning Sign for Stroke'

BP fluctuationsLast week we addressed a report from the Institute of Medicine indicating that high blood pressure is not on the minds of the general public. However, in the most recent issue of the Lancet, a different view of hypertension was posted: what if your physician is looking at the wrong BP values? What if there is more to clinic blood pressure, or the measurement that your physician takes, than the average value?

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Back to the Basics of Blood Pressure

Blood pressureAlmost everyone knows that blood pressure is one of the most important measurements in medicine. Every time a patient visits a physician's office or hospital, one of the first measurements taken is their blood pressure. Since blood pressure plays such a vital role in monitoring a person's overall health, I thought I would write about the basics of blood pressure and some of the terminology used in blood pressure measurement.

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Online Blood Pressure Measurement Resources

a simple guide to blood pressure

Since our initial blog post '10 steps to Accurate Manual Blood Pressure Measurement', we've had a few readers contact us seeking some more resources related to taking manual blood pressures and hypertension in general. Below are a couple of websites we've found helpful on these topics.

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10 Steps to Accurate Manual Blood Pressure Measurement

Picture of Accurate Manual Blood Pressure MeasurementWorking for a company that develops blood pressure monitoring devices and technologies, I deal with blood pressure on some level every day. We make accurate and reliable blood pressure measurement our business...literally. So, it only makes sense that we should care about accurate blood pressure measurement from a fundamental perspective, which is the inspiration for my first blog post.

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