Takeaway

• The American Heart Association (AHA) has issued a scientific statement on the measurement of BP, with a wide range of information on everything from technique, timing, and devices to best approaches in specific patient populations.

Why this matters

• The statement is a timely update of a 2005 scientific statement and follows on the 2017 guidelines from the AHA and partner organizations.
• The authors take a close look at oscillometric devices.

Key highlights

• The statement takes a close look at appropriate cuff size, correct body position, and competence of the person doing the measurement.
• It offers a table that breaks proper measurement technique into 6 steps:
  • Patient preparation: 3-5 minutes seated without talking, feet flat on floor, back supported; exam table is not appropriate.
  • Proper technique: validated device, correct cuff size and position.
  • Proper measurement: first record in both arms, use the arm with higher reading for future; separate repeats by 1-2 minutes.
  • Proper documentation: record systolic/diastolic values to nearest even number.
  • Average: average ≥2 readings on ≥2 occasions for proper BP estimation.
  • Tell the patient their readings.
• Algorithms for distinguishing white-coat vs masked hypertension also provided.
• Addresses specific populations, such as pediatrics, pregnancy, and technology (e.g., smartphone measurement).