Clinical Review

Blood pressure measuring devices: recommendations of the European Society of Hypertension

BMJ 2001; 322 doi: http://dx.doi.org/10.1136/bmj.322.7285.531 (Published 03 March 2001) Cite this as: BMJ 2001;322:531
  1. Eoin O'Brien (eobrien@iol.ie), professor of cardiovascular medicinea,
  2. Bernard Waeber, professorb,
  3. Gianfranco Parati, associate professorc,
  4. Jan Staessen, lecturerd,
  5. Martin G Myers, professore the European Society of Hypertension Working Group on Blood Pressure Monitoring.
  1. a Blood Pressure Unit, Beaumont Hospital, Dublin 9, Ireland
  2. b Centre Hospitalier Universitaire Vaudois, Division D'Hypertension, Departement de medecine interne, 1011 Lausanne, Switzerland
  3. c Universita degli Studi di Milano-Biocca, Istituto Scientifico Ospedale San Luca, IRCCS, Istituto Auxologico Italiano, Via Spagnoletto 3, 20149 Milan, Italy
  4. d Katholieke Universiteit Leuven, Hypertensie en Cardiovasculaire Revalidatie Eenheid, Inwendige Geneeskunde-Cardiologie, UZ Gasthuisberg, 3000 Leuven, Belgium
  5. e Division of Cardiology, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5
  1. Correspondence to: E O'Brien
  • Accepted 17 November 2000

There is a large market for blood pressure measuring devices not only in clinical medicine but also among the public where the demand for self measurement of blood pressure is growing rapidly. For consumers, whether medical or lay, accuracy should be of prime importance when selecting a device to measure blood pressure. However, most devices have not been evaluated for accuracy independently using the two most widely used protocols: the British Hypertension Society (BHS) protocol and the standard set by the US Association for the Advancement of Medical Instrumentation (AAMI). 1 2 The Working Group on Blood Pressure Monitoring of the European Society of Hypertension has decided to review blood pressure measuring devices regularly to guide purchasers.3 For this first report devices for which there is published evidence of independent validation using these protocols have been surveyed. Because most blood pressure devices have not been independently validated, only a fraction of the many devices available have been surveyed. Devices that have been validated recently for which results have not yet been published were not included, but this shortcoming should be addressed in future.

Summary points

Two manual sphygmomanometers have been validated, one is recommended

Five devices for clinical use in hospitals have been validated, two are recommended

23 devices for self measurement of blood pressure have been validated, five are recommended

24 devices for ambulatory measurement of blood pressure have been validated, 16 are recommended

Validations and recommendations will be updated on the BMJ's website

Methods

Validation standards

In 1987, the American Association for the Advancement of Medical Instrumentation published a standard for sphygmomanometers which included a protocol for evaluating the accuracy of devices.4 In 1990 a protocol was devised by the British Hypertension Society.5 Both protocols have since been revised. 1 2 Since the two protocols can be reconciled the …

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