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Beyond office sphygmomanometry: Ways to better assess blood pressure
Cleveland Clinic Journal of Medicine, 11/03/09

Rafey M – To diagnose and manage hypertension optimally, we may need to do more than measure the patient’s blood pressure in the office using traditional sphygmomanometry. A variety of devices—some already available, validated, and reimbursable, some still in development – provide more information and give us a better picture of the patient’s true hypertensive status, degree of blood pressure control, and risk of end–organ damage.

• Traditional office blood pressure measurements have diagnostic limitations, since they are only snapshots of a very dynamic variable.
• Ambulatory 24–hour blood pressure monitoring is a useful and proven tool and can reveal nocturnal hypertension, a possible new marker of risk.
• Automatic devices can be used in the clinician’s office to minimize the “white coat effect” and measure blood pressure accurately.
• Pulse–wave analysis provides physiologic data on central blood pressure and arterial stiffness. This information may help in the early identification and management of patients at risk for end–organ damage.

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