What is the appropriate means of measuring BP?
Measuring BP in the office should be performed with individuals seated for at least 5 minutes in a chair with their feet on the ground and an arm supported at the level of the heart. An appropriate-sized cuff with the cuff bladder encircling at least 80% but no more than 100% of the upper arm should be used; attention should be paid to ensure the bladder covers the brachial artery. While the “gold standard” remains a mercury sphygmomanometer, electronic (oscillometric) monitors have grown in popularity, and are being utilized in both clinical trials and office-based practice. Ausculatory oscillometric blood pressure (AOBP) devices were used in trials such as SPRINT and ACCORD, but they provide readings that are 5 to 10 mm Hg systolic lower than conventional office measurements. Electronic units are simpler to use and can be set on a timer, which allows the provider to leave the room (thereby reducing the white coat effect). Moreover, they do not have the environmental concerns of mercury-based devices. However, many offices do not have a separate quiet room nor the time to measure BP in this way.