Measurement of blood presssure: an evidence based review

This is the first in a series of five articles on the treatment of hypertension

The reasons for routinely measuring blood pressures in adults are evident. Raised blood pressure is a common condition that does not have specific clinical manifestations until target organ damage develops. It confers a substantial risk of cardiovascular disease (particularly in the presence of concomitant risk factors), much of which is at least partially reversible with treatment. Finally, screening adults to detect hypertension early and initiate treatment before the onset of target organ damage is highly cost effective.1

Accurate measurement is of paramount importance. For example, consistently underestimating the diastolic pressure by 5 mm Hg could result in almost two thirds of hypertensive individuals being denied potentially lifesaving—and certainly morbidity preventing—treatment2; consistently overestimating it by 5 mm Hg could more than double the number of individuals diagnosed as hypertensive (half of whom would be inappropriately labelled and treated).2