Home Blood Pressure Measurement: A Review

Home Blood Pressure Measurement: A Review

Gurmanik Kaur (SLIET, India), Ajat Shatru Arora (SLIET, India) and Vijender Kumar Jain (SLIET, India)
DOI: 10.4018/978-1-4666-0282-3.ch017
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Abstract

Hypertension, the leading global risk factor for early mortality, cannot be detected or treated without accurate and practical methods of blood pressure (BP) measurement. Although home BP measurement has considerable popularity among patients, the lack of evidence needed to assure its place in modern clinical practice has hindered its widespread acceptance among physicians. This paper demonstrates that home BP measurement is more accurate than conventional clinic and ambulatory monitoring BP measurement and can be used effectively in clinical practice. On the basis of the data from different studies, it can be concluded that home BP measurement is an improvement over conventional clinic BP measurement. Home monitoring of BP is a convenient, accurate, and widely available option and may become the method of choice when diagnosing and treating hypertension. A paradigm shift is needed in BP measurement as evidence-based medicine suggests that clinic BP measurement should only be used for screening purposes.
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History Of Home Bp Measurement

The standard method of indirect measurement of BP is based on the principle of arterial occlusion and BP detection by various techniques, the first of which was palpation, described by Scipione Riva-Rocci in 1896. In 1905, Nikolai Korotkoff improved Riva-Rocci’s method when he recognized that by placing a stethoscope over the brachial artery at the cubital fossa, distal to a Riva-Rocci cuff, tapping sounds could be heard as the cuff was deflated, caused by blood flowing back into the artery. Korotkoff concluded correctly that the appearance of the tapping sounds coincided with systolic BP and the disappearance of the sounds with diastolic BP (Korotkoff, 1905). The method of BP measurement invented by Korotkoff quickly received wide recognition and became a standard medical procedure. His technique has truly stood the test of time as it has been used for more than a century with practically no alterations (Booth, 1977).

Brown was the first to report that BP measured in the home was lower than that recorded by a doctor (Brown, 1930). Ayman and Goldshine proposed the concept of “self BP measurement” in 1940 and also concluded that BP measured at home was lower than clinic BP. They have also suggested that home BP monitoring was useful for (1) instructing the patients about their chronic diseases, (2) teaching physicians about the natural course of the disease and about factors that affect the disease, (3) learning the prognosis of disease, and (4) increasing the precision of determining the effectiveness of treatment, as all of these hypotheses are slowly being proved correct (Ayman, 1940).

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