BLOOD-PRESSURE MEASUREMENT

Cardiovascular diseases account for over half of all deaths in industr ialized societies, and hypertension is one of the most treatable and p reventable risk factors underlying that impressive statistic. Implicit in population and community control programs for high blood pressure is the recognition, evaluation and treatment of patients with elevated arterial pressures. The indirect measurement of arterial pressure has been available only within the past century, and the definition of pr ocedures and techniques for its widespread use have been introduced on ly within the past few decades. The development of guidelines and reco mmendations for sphygmomanometry has been aided by epidemiological cri teria and national hypertension programs worldwide. These guidelines h ave permitted identification of large numbers of patients with hyperte nsion. Implicit in the screening of populations is the necessity to co nfirm the elevated arterial pressure on at least three separate occasi ons before diagnosis and treatment are instituted (unless the clinicia n deems that a hypertensive urgency or emergency exists). A number of pitfalls and practical considerations are discussed, and pertinent ref erences to currently published guidelines are presented.