Bmj Usa: Editorial

How should we take blood pressure in clinical practice?: The wider use of home and ambulatory monitoring should be encouraged

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E150
  1. Thomas G Pickering, professor of medicine (
  1. Marie-Josée and Henry R Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York, NY 10029–6574

    From BMJ USA 2002;October:541

    It is increasingly clear that the traditional way of measuring blood pressure in the clinic or office frequently produces numbers that grossly overestimate a patient's true blood pressure level. This is a major problem, since it is one of the most important and frequent measurements made by physicians. Two major trends have brought this issue to the forefront: first, the development of new technologies for measuring blood pressure; and second, the increasing body of evidence that even mild elevations of blood pressure are associated with increased cardiovascular risk.

    The traditional gold standard for evaluating blood pressure has been clinic readings made by a physician using a mercury sphygmomanometer. It is hallowed by time, and also by the fact that it has been the standard method for evaluating the risks associated with high blood pressure and the benefits of treating it. It has been known for more than 50 years that the blood pressures recorded in …

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