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June 4, 2003

Accurate Measurement of Blood PressureAccurate Measurement of Blood Pressure

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(21):2792-2794. doi:10.1001/jama.289.21.2792-a

To The Editor: Dr Jones and colleagues1 highlighted many important sources of error in blood pressure measurement. There are 3 main sources of error: technique, observer bias, and faulty equipment.2 Of all the possible sources of error, only one cannot be overcome through proper training, namely, that of faulty equipment. As Jones et al point out, the mercury sphygmomanometer has been the criterion standard for blood pressure measurement. Nonetheless, concerns about mercury toxicity have led to its recent removal from hospitals and clinics.3 Unlike mercury sphygmomanometers, however, aneroid sphygmomanometers require regular calibration. Much of the reluctance concerning the continued use of mercury devices may have come from broken glass thermometers. Modern mercury sphygmomanometers, on the other hand, are generally safe against accidental spillage.4 With accurate blood pressure measurement an essential part of every clinical visit, I believe that the mercury sphygmomanometer should remain an essential component of every clinical examination room until other instruments are better validated.

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