Instructions for Proper Office Blood Pressure Measurement

Conditions

 • Quiet room with comfortable temperature.

 • Before measurements: Avoid smoking, caffeine and exercise for 30 min; empty bladder; remain seated and relaxed for 3–5 min.

 • Neither patient nor staff should talk before, during and between measurements.

Positions

 • Sitting: Arm resting on table with mid-arm at heart level; back supported on chair; legs uncrossed and feet flat on floor (Figure 1).

Device

 • Validated electronic (oscillometric) upper-arm cuff device. Lists of accurate electronic devices for office, home and ambulatory BP measurement in adults, children and pregnant women are available at www.stridebp.org

 • Alternatively use a calibrated auscultatory device, (aneroid, or hybrid as mercury sphygmomanometers are banned in most countries) with 1st Korotkoff sound for systolic blood pressure and 5th for diastolic with a low deflation rate.

Cuff

 • Size according to the individual’s arm circumference (smaller cuff overestimates and larger cuff underestimates blood pressure).

 • For manual auscultatory devices the inflatable bladder of the cuff must cover 75%–100% of the individual’s arm circumference. For electronic devices use cuffs according to device instructions.

Protocol

 • At each visit take 3 measurements with 1 min between them. Calculate the average of the last 2 measurements. If BP of first reading is <130/85 mmHg no further measurement is required.

Interpretation

 • Blood pressure of 2–3 office visits ≥140/90 mmHg indicates hypertension



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