Mercury Sphygmomanometers Should Not be Abandoned: An Advisory Statement From the Council for High Blood Pressure Research, American Heart Association

In healthcare institutions around this country and around the world, mercury sphygmomanometers are being removed.1 In many situations, the decision to replace the instruments is being made without significant input from involved clinicians or consideration of the health risks that will follow if they are replaced by less accurate devices.Blood pressure measurement is an important indicator of the current clinical condition of patients and a powerful predictor of future cardiovascular and overall health.2 Blood pressure measurement is often considered “routine” and is often performed by those with the least training. In many institutions, blood pressure measurement is a low priority, with less than ideal quality control related to equipment selection, equipment calibration and repair, and personnel training and performance.For more than a century, the mercury gravity sphygmomanometer has been the gold standard for indirect measurement of blood pressure. Indeed, the world primary standard for pressure measurement is a mercury manometer. It is a simple, gravity-based unit with easy calibration, infrequent need for repair, and it has been validated in many clinical circumstances against direct intra-arterial blood pressure measurement.3 In recent years, these mercury units have been replaced with aneroid instruments in many institutions and more recently with electronic manometers. Justifications for the replacement of mercury manometers have included concerns about the safety of mercury, concerns about regulations regarding the use …