Blood Pressure Measurement in Childhood Epidemiological Studies

Although relatively economical and easy to use, the standard mercury sphygmomanometer is subject to the bias resulting from knowledge of earlier readings. The random-zero sphygmomanometer overcomes this bias, but it is more expensive and difficult to use and may underestimate blood pressure levels. In contrast to auscultatory devices, automated oscillometric devices are not subject to observer biases. They are gaining wider use and may be especially appropriate for younger children. However, they are expensive, and each model requires validation before use in epidemiological studies. Ambulatory blood pressure monitoring represents a potentially useful technique for future epidemiological studies. Multiple measurements are vital in estimating a child's blood pressure, and the number of visits, days or weeks apart, is at least as important as the number of measurements per visit.