Demise of the mercury sphygmomanometer and the dawning of a new era in blood pressure measurement

After a little more than a century of use, the conventional Riva-Rocci/Korotkoff technique of measuring blood pressure with a mercury sphygmomanometer and stethoscope, is now being relegated to the museum shelves. Affectionately attached though we may be to this clinical measurement, we must acknowledge that the technique is fraught with inaccuracy and that the age of technology has brought more accurate alternative methodologies. However, we must ensure that the automated devices that are replacing the conventional technique are validated independently for accuracy. The Working Group on Blood Pressure Monitoring of the European Society of Hypertension has recently published an International Protocol to facilitate the validation of more automated devices than was possible with the earlier more complicated protocols.