In Reply: Dr Coplan raises questions about several aspects of the measurement of blood pressure. Single measurement of blood pressure was a potential limitation we discussed in the article. Further studies on blood pressure levels of active National Football League players are currently under way using a protocol of 3 blood pressure measurements.
Our protocol was designed to minimize blood pressure measurement variability across all 12 teams. A validated automated blood pressure measurement device chosen by the authors was used by all teams. As noted in the study methodology, potential cuff size errors that can contribute to measurement inaccuracy were addressed by having researchers measure each player's biceps circumference and assign the appropriate cuff size per the manufacturer's instructions.
Tucker AM. Assessing Cardiovascular Risk Factors in National Football League Players—Reply. JAMA. 2009;302(11):1166. doi:10.1001/jama.2009.1328