Brief Reviews Measurement of Blood Pressure in the Office Recognizing the Problem and Proposing the Solution

The widely accepted cut-point for normal blood pressure (BP) in the office setting evolved over several decades, based on data derived from a variety of sources. The Actuarial Society of America was one of the first organizations to publish BP data on thousands of community residents, followed by other classic studies such as Framingham, Western Electric Company, Kaiser Permanente, and the Multiple Risk Factor Intervention Trial.1,2 In every instance, BP readings were based on measurements taken by specially trained health professionals following guidelines for proper BP measurement. As a result of these and other population studies examining the association between different BP levels and cardiovascular outcomes, the importance of systolic and diastolic hypertension was recognized and an office BP of 140/90 mm Hg became the universally established cut-point for separating normal BP from hypertension.