Cleveland Family Study

2.1 Background

Blood pressure (BP) readings of high quality are fundamental to diagnosis and treatment of hypertension. Yet many factors, including influences of the subject, the observer, the equipment, and the circumstances of the measurement, work against the attainment of this basic objective. Good results cannot be taken for granted, then, and special attention must be focused on BP measurement procedures.

These procedures for BP recording were developed for the Family Study after extensive consideration and discussion of numerous approaches to measurement techniques. In addition to the selection of instruments and specification of criteria for measurements, Family Study specifies methods for the entire sequence of steps in BP recording. For all observers, whether inexperienced in BP measurement or accustomed to different procedures, it will be important to become intimately familiar with these procedures and to carry them out, as early as possible, as a matter of habit.

It should be emphasized that the steps outlined here can satisfactorily be followed for the vast majority of adult subjects participating in ambulatory care. Exceptional situations do, of course, arise with occasional serious obstacles to successful BP measurement. It must be the responsibility of supervisory staff to encourage BP observers to note exceptional circumstances and to seek consultation when they arise so participants will be appropriately evaluated.