Getting an accurate blood pressure reading is neither easy nor straightforward. Although the reading itself is not difficult, the tricky part is the process of actually finding one's blood pressure. For the most precise reading possible, a device must be inserted into the patient to get this most accurate of readings. This procedure is invasive, not too commonly used as such accuracy is rarely necessary.

More commonly used is an instrument called a sphygmomanometer. The sphygmomanometer is normally referred to as the blood pressure cuff. An apt description since that is how it is placed on the upper arm. It is in fact a long pressurized sock, wound round the upper arm giving the appearance of a cuff.

Usually wound round the upper left arm, the cuff is placed more or less at the same vertical height as the patient's heart. The person must be sitting down in an upright position as this is the optimal position for blood to flow through the body as it should. The cuff is then inflated with a small pump until there is sufficient pressure on the brachial artery to give a reading.

Systolic pressure will be taken first. The doctor places his stethoscope against the inside of the elbow joint. He will decrease the pressure in the cuff until he hears the Korotkoff sounds through the stethoscope. This is when the systolic reading is taken.

He will continue to deflate the cuff until the Korotkoff sounds cease and this is the reading for the diatolic pressure.

Nowadays, the digital blood pressure cuff has become popular. Both systems have their pros and cons. For the unskilled patient who takes his own blood pressure at home or have it taken in a drug store, the digital cuff is easier to use. The digital cuff is more practical in a noisy environment since there is no listening for the Korotkoff sounds required. The digital cuff types work by measuring the mean arterial pulse, and it derives both pressures (systolic and diatolic) from that. It is limited in that it cannot be used by all patients, those with particular health problems.

Doctors and health care practitioners normally use the manual sphygmomanometer. It takes skill to operate it but it is more precise than a digital one. It takes a certain amount of practice to master listening for the Korotkoff sounds while manually pumping the cuff. Without the necessary skill and practice, people find the manual sphygmomanometer difficult to operate.



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