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      Wrist Measurement of Blood Pressure: Some Critical Remarks to Oscillometry

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          Abstract

          Oscillometric blood pressure measuring devices worn at the wrist are preferred by a growing part of hypertensive patients for self–measurement because of their compactness and ease of use. However, little is known about the accuracy of such instruments. The accuracy of such devices was evaluated by measuring the blood pressure at the end of a coronary angiography procedure in 27 subjects nearly simultaneously in the aortic arch, using a Statham P23 transducer, and at the wrist, using the blood pressure watch (BPW) by NAIS–Matsushita. Four replicate comparative measurements were performed in each subject. On average, the blood pressure measured by the BPW was found to be higher: systolic +1.2±(SD)10.2 mm Hg, diastolic +4.1±7.2 mm Hg. The correlation coefficient between the two methods was 0.85 for the systolic and 0.84 for the diastolic pressure, but 39% of the systolic and 22% of the diastolic differences were outside the range of ±1 SD. There was no correlation between systolic differences and blood pressure or patients’ variables, but multiple regression analysis revealed that the diastolic blood pressure differences were negatively correlated with the aortic diastolic pressure (r = 0.89, p<0.001), indicating that the BPW is less accurate to detect lower values. Conclusions: (1) Though the average systolic and diastolic deviations between both methods and the relative correlation coefficients suggest that the BPW is to be used carefully for monitoring blood pressure, the great variability of differences and the inability of the BPW to detect lower diastolic blood pressure calls for a mandatory validation test by an approved protocol before this new device can be recommended for general use. (2) On the basis of our results for wrist oscillometry with the BPW and data reported in the literature for upper–arm oscillometric devices, we recommend to use oscillometric devices only when they were validated properly. In particular, the oscillometric measurement should be employed with caution for epidemiological studies or for investigation of population groups (e.g., children or pregnant women) that are expected to display lower diastolic pressures.

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          Most cited references 1

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          Blood pressure measurement and detection of hypertension.

           T Pickering (1994)
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            Author and article information

            Journal
            KBR
            Kidney Blood Press Res
            10.1159/issn.1420-4096
            Kidney and Blood Pressure Research
            S. Karger AG
            1420-4096
            1423-0143
            1999
            1999
            25 June 1999
            : 22
            : 3
            : 161-165
            Affiliations
            Zentrum für Innere Medizin, Universitätsklinik Essen, Deutschland
            Article
            25923 Kidney Blood Press Res 1999;22:161–165
            10.1159/000025923
            10394116
            © 1999 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 4, References: 16, Pages: 5
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/25923
            Categories
            Original Paper

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