Blood pressure measurement

Part IV—Automated sphygmomanometry: self blood pressure measurement

It has been recognised for over 50 years that blood pressure measured in the home is lower than that recorded by a doctor.1 The discrepancy between pressures recorded in the home and the clinic has been confirmed repeatedly, and is present regardless of whether patients, or their relatives or friends, measure blood pressure.2

Why then has home measurement of blood pressure failed to achieve the success and popularity of home urinalysis in diabetes? There are a number of explanations: training patients to measure their own blood pressures using the auscultatory technique was troublesome and time consuming and not suitable for many subjects; the technique is subject to bias whereby some patients record pressures of their own making; doctors often perceive the technique as one which induces anxiety or causes the patient to take an obsessional interest in blood pressure; most automated devices available for self measurement had not been validated adequately, or had been shown to be inaccurate; finally, because the technique was little used data have been lacking to provide the evidence needed to assure its place in modern clinical practice.

For these reasons home measurement of blood pressure has not received widespread acceptance in medical practice, although its popularity with patients is considerable. However, the advent of accurate inexpensive automated devices which can provide a printout of blood pressure measurement with the time and date of measurement, or which allow storage of data for later analysis, plotting and/or electronic transmission of data, has removed many of the drawbacks referred to above, and there is now a renewed interest in self blood pressure measurement. This revival of interest in an old methodology was recognised when experts from around the world gathered at the First International Consensus Conference on Self-Blood Pressure Measurement (SBPM) …