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Blood pressure in hospitalized patients: should we still measure it?

B lood pressure measurement is one of the most frequently performed medical procedures in ambulatory medicine but also in hospitalized patients. In most clinical wards around the world, blood pressure is measured several times a day in every patient and values are carefully reported on the medical charts. Historically, blood pressure was measured so often not to detect high blood pressure or diagnose arterial hypertension but essentially as a vital sign that should provide information on the stability of the cardiovascular system and be a potential predictor of clinical events that might happen during the patient’s hospitalization [1]. The importance of blood pressure monitoring in emergency wards or ICUs is undeniable and will not be discussed here. However, the clinical relevance of measuring blood pressure again and again in patients admitted in medical or surgical wards is regularly questioned. The first common criticism relates to the quality of blood pressure measurements performed by nurses and physicians in the context of the hospital. There have been several publications on the accuracy of blood pressure measuring devices and on the protocol used to measure blood pressure, if any [2–4]. In fact, it seems rather obvious that most hospitals do not use a standardized operational procedure to measure blood pressure in admitted patients and hence blood pressure values are acquired in many different conditions (sitting, standing, supine and so on). Interpretation of such measurements would be very difficult unless extreme values are obtained. In fact, it is rather surprising that very few studies have actually assessed the quality of blood pressure measurements in a large group of hospitalized patients. This is the merit of the study of