The oscillometric technique has been used successfully in ambulatory blood pressure monitors and home monitors. The main disadvantage is that such recorders do not work well during physical activity when there may be considerable movement artifact. This method is advantageous in that no transducer need be placed over the brachial artery, and it is less susceptible to external noise (but not to low frequency mechanical vibration), and that the cuff can be removed and replaced by the patient during ambulatory monitoring, for example, to take a shower. 1), so that systolic and diastolic pressure can only be estimated indirectly according to some empirically derived algorithm.

32, 39, 97 The oscillations begin at approximately systolic pressure and continue below diastolic ( Fig. This was first demonstrated by Marey in 1876, 38 and it was subsequently shown that when the oscillations of pressure in a sphygmomanometer cuff are recorded during gradual deflation, the point of maximal oscillation corresponds to the mean intra-arterial pressure. Blood pressure measurements in different circumstances and in special populations such as infants, children, pregnant women, elderly persons, and obese subjects are discussed. Practical advice is given on how the different devices and measurement techniques should be used.

The devices currently available for hospital and clinic measurements and their important sources of error are presented. In this article, the basic techniques of blood pressure measurement and the technical issues associated with measurements in clinical practice are discussed. This has led to the proliferation of non-mercury devices and has changed (probably for ever) the preferable modality of blood pressure measurement in clinic and hospital settings.

To date, mercury devices have largely been phased out in US hospitals. Although the mercury sphygmomanometer is widely regarded as the “gold standard” for office blood pressure measurement, the ban on use of mercury devices continues to diminish their role in office and hospital settings.

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