How to Best Assess Blood Pressure?

Abstract

See related article, pp 1087–1093 It is half a century since high blood pressure (BP) measured in the doctor's office has been proved to be a strong predictor of cardiovascular morbidity and mortality. However, it soon became clear that multiple factors can significantly affect the BP measurement result (Table 1) and may thereby have considerable impact on its prognostic ability. View this table: Table 1. Aspects of the BP Measurement That Might Influence Its Assessment Despite the intensive research with almost 120 000 PubMed papers on issues related to BP monitoring, the question “how to best assess BP” is still a matter of hot debate. Notwithstanding these difficulties, research in the field of BP monitoring has considerably refined the BP measurement procedure, by systematically addressing all factors listed in Table 1. Such improvement has included a better standardization of methods as well as the development of multiple approaches to BP quantification, aiming to more precise risk prediction. This was achieved not only by a more accurate estimation of mean BP, but also by the evaluation of different patterns of BP variation over time. Although, irrespective of the measurement methodology (Table 1), any BP value is by itself a powerful index of risk, several aspects of BP dynamics assessed by considering patterns of BP change over time have been proved to increase the prognostic ability of BP, over and above the information provided by conventional office measurements. Practicing physicians, as well as patients themselves (particularly …