, every 1 2 years, based on manufacturer recommendations), than aneroid devices.3 1 Have the patient relax, sitting in a chair (feet on floor, back supported) for > 5 min 2 The patient should avoid caffeine, exercise, and smoking for at least 30 min before measurement 3 Ensure patient has emptied his/her bladder 4 Neither the patient nor the observer should talk during the rest period or during the measurement 5 Remove all clothing covering the location of cuff placement 6 Measurements made while the patient is sitting or lying on an examining table do not fulfill these criteria 1 Use a BP measurement device that has been validated, and ensure that the device is calibrated periodically 2 Support the patient s arm (e.g., resting on a desk) 3 Position the middle of the cuff on the patient s upper arm at the level of the right atrium (the midpoint of the sternum) 4 Use the correct cuff size, such that the bladder encircles 80% of the arm, and note if a larger- or smaller-than-normal cuff size is used 5 Either the stethoscope diaphragm or bell may be used for auscultatory readings 1 At the first visit, record BP in both arms. Use the arm that gives the higher reading for subsequent readings 2 Separate repeated measurements by 1 2 min 3 For auscultatory determinations, use a palpated estimate of radial pulse obliteration pressure to estimate SBP. Inflate the cuff 20 30 mm Hg above this level for an auscultatory determination of the BP level 4 For auscultatory readings, deflate the cuff pressure 2 mm Hg per second, and listen for Korotkoff sounds 1 Record SBP and DBP. 