Blood pressure measurement Hanna Tolonen National Public Health Institute, Finland.

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Presentation transcript:

Blood pressure measurement Hanna Tolonen National Public Health Institute, Finland

HES Workshop, Luxembourg, 9-11 April 2008 Critical issues Choice of the blood pressure measuring device Posture of the subject and arm during the measurement Selection of correct cuff size Standardization of the measurement protocol Training

HES Workshop, Luxembourg, 9-11 April 2008 Measurement device Aneroid sphygmomanometer Simple mercury sphygmomanometer Automated bp device

HES Workshop, Luxembourg, 9-11 April 2008 Directive 2007/51/EC 1. May not be placed on the market: (a) in fever thermometers; (b) in other measuring devices intended for sale to the general public (e.g.manometers, barometers, sphygmomanometers, thermometers other than fever thermometers). … 3. By 3 October 2009 the Commission shall carry out a review of the availability of reliable safer alternatives that are technically and economically feasible for mercury containing sphygmomanometers and other measuring devices in healthcare and in other professional and industrial uses. On the basis of this review or as soon as new information on reliable safer alternatives for sphygmomanometers and other measuring devices containing mercury becomes available, the Commission shall, if appropriate, present a legislative proposal to extend the restrictions in paragraph 1 to sphygmomanometers and other measuring devices in healthcare and in other professional and industrial uses, so that mercury in measuring devices is phased out whenever technically and economically feasible.

HES Workshop, Luxembourg, 9-11 April 2008 Used measurement devices Simple mercury sphygmomanometer considered ’golden standard’ In past national HES: Mercury sphygmomanometer: 50% Automated device: 50% Aneroid sphygmomanometer: No information about the use in any of the national HES

HES Workshop, Luxembourg, 9-11 April 2008 Legal restrictions and other limitations For the use of mercury sphygmomanometer Asked from country contact persons in June 2007 Replies from 19 countries Use allowed in all countries (some local limitations) In some countries it is getting difficult to Obtain service (cleaning, testint, etc.) Find new devices on the market

HES Workshop, Luxembourg, 9-11 April 2008 Conclusions Traditionally mercury sphygmomanometers are recommended Protocol can be standardized Requires Extensive training Passed audiogram for the measurers Automated devices often used Problems with the comparability between devices and in time trends