A standard method for measuring blood pressure in the Americas
Mirta Roses PeriagoI; Claude LenfantII
IDirector, Pan American Health Organization, Washington, D.C., United States of America
IIPast Director, National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Maryland, United States of America
Hypertension, or high blood pressure, is a silent but dangerous disease affecting an estimated 140 million men and women of all ethnic backgrounds in the Americas (1). This condition results in disability and millions of premature deaths each year from stroke and heart disease, heart failure, and kidney failure. It is estimated that strokes, heart attacks, and kidney failures resulting from hypertension comprise more than half the mortality in the Americas. These diseases cause untold suffering and lead to major social impacts, economic losses, and reduced productivity in every nation in the Western Hemisphere (2).
Since the days of Korotkoff almost 100 years ago, the measurement of blood pressure has been an important clinical and epidemiology procedure. Because it is noninvasive and easily done, it is perhaps one of the most widely performed medical procedures.
One challenge is that blood pressure is not yet measured in a uniform and consistent manner within and across nations and regions. As a result, research results and program plans may not be transferable or applicable to other groups or nations. In addition, some research data cannot be compared or the results pooled, thus losing important opportunities for evidence-based information on national and hemispheric trends and impacts of national prevention, education, and control efforts.
A standard method for measuring blood pressure for the Americas is an attempt to resolve this issue. Such a standard has now been developed by an international team of experts under the auspices of the Pan American Hypertension Initiative (PAHI), and it is presented in this issue of the Revista Pamamericana de Salud Publica/Pan American Journal of Public Health (3). PAHI was launched in 1999 by the Pan American Health Organization in cooperation with the National Heart, Lung, and Blood Institute and seven international organizations interested in cardiovascular disease prevention and control in the region of the Americas. It is anticipated that the proposed blood pressure measurement standard will become an important new tool in international comparisons and assessment of disease trends in the Region. Nations in the Americas are encouraged to adopt the common protocol. When data are collected and reported in a similar manner, it provides the opportunity to observe real trend differences between nations. This is an important issue if community interventions are to be compared and their impact measured. Adopting the common protocol would also help to disseminate "best practices" and other successful experiences, making them examples that would further speed wider implementation by policymakers and health professionals.
1 Pan American Hypertension Initiative. Pan American Hypertension Initiative [Internet site]. Available from: http://www.mco.edu/org/whl/pahi.html. Accessed 12 September 2003.
2 Pan American Health Organization. Health in the Americas, 2002 edition. Volume I. Washington, D.C.: PAHO; 2002. (PAHO Scientific and Technical Publication No. 587).
3 Pan American Hypertension Initiative. Working meeting on blood pressure measurement: suggestions for measuring blood pressure to use in populations surveys. Rev Panam Salud Publica 2003:14(5):300302.