Cardiovascular Disease: Hypertension & Coronary Artery Disease

Appendix A: AHA-ACC Blood Pressure Measurement

Blood pressure (BP) measurements in the office or clinic setting as adapted from Pickering et al.,4 and Black et al.5

• Caffeine, exercise, and smoking should be avoided for at least 30 minutes prior to measurement.
• The patient should be seated comfortably for 5 minutes with the back supported and the upper arm bared without constrictive clothing. The legs should not be crossed.
• The arm should be supported at heart level and the bladder of the cuff should encircle at least 80% of the arm circumference.
• The mercury column should be deflated at 2 to 3 mm/s, and the first and last audible sounds should be taken as systolic and diastolic pressure. At least two measurements should be measured 1 minute apart with the averaged recorded. If there is >5 mm Hg difference between the first and second readings, additional (1 or 2) readings should be obtained and then the average of these multiple readings is used.
• Neither the patient nor the observer should talk during the measurement.