Systolic Hypertension in the Elderly Program (SHEP). Part 5: Baseline blood pressure and pulse rate measurements.

In preparation for blood pressure determination, the midarm circumference was measured on the bared right upper arm, with the participant standing. The appropriate size cuff was then selected from a chart of arm circumference measurements and corresponding cuff sizes (Table 5.1) (SHEP Blood Pressure Manual). Measurements of blood pressure and pulse rate were performed only after the participant had been seated quietly for at least 5 minutes, in a comfortable posture, with feet flat on the floor. The elbow and forearm were to be rested comfortably on the table. The radial pulse was palpated and counted for 30 seconds and then recorded in beats per minute. Blood pressures were measured with use of a random-zero device (Hawksley Random-Zero sphygmomanometer, Sussex, England). The cuff was applied and gradually inflated, with the radial pulse palpated to determine peak inflation level. The reading was taken in the sitting position with the arm at or as close to the level of the heart as possible. After 30 seconds, the first of two measurements was taken, with a 30-second interval between the measurements. The cuff was deflated at a constant rate of 2 mm/sec until 10 mm Hg below the level of the diastolic reading was reached, recorded to the nearest even number. Blood pressure readings were recorded as the first (systolic) and fifth (diastolic) phase Korotkoff sounds. Blood pressures were also taken after 1 and 3 minutes of the participant standing; with use of a Mayo stand, the arm was positioned at the level of the heart. Blood pressure readings at baseline visit 2 preceded the venipuncture that was also done during this visit.