Most clinical offices rely on automated oscillometric devices to measure blood pressure
(BP), but the accuracy of this technique versus auscultatory determination using a
mercury manometer is controversial. To assess the accuracy of automated oscillometric
readings, BP was measured from the same site and cuff, in 337 consecutive patients
seen in a routine cardiology office, using a simultaneous connection to an automated
oscillometric and a mercury manometer technique. The mean systolic BP (133 ± 20 mm
Hg) and diastolic BP (72 ± 11 mm Hg) were significantly greater using the mercury
manometer than the automated oscillometric technique (systolic 131 ± 18 and diastolic
70 ± 12 mm Hg, p <0.0001). Discrepancies (almost always lower oscillometric and greater
mercury manometer) in systolic BP were seen in 22% of all patients. Discrepancies
in diastolic BP were seen in 20% of all patients. The mean of the discrepancy between
the 2 techniques was 1.95 ± 5 mm Hg (range 1 to 26) for systolic BP and 1.3 ± 4 mm
Hg (range 1 to 25) for diastolic BP. The discrepancies were greater in patients >65
years. In conclusion, the mercury manometer technique resulted in consistently greater
BP values than oscillometric devices. These findings have important clinical implications,
including the concept that patients whose BP appears to be under control using the
oscillometric technique might not be at their goal BP and might have been undertreated.
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Article info
Publication history
Published online: May 24, 2010
Accepted:
March 4,
2010
Received in revised form:
March 4,
2010
Received:
January 20,
2010
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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- Oscillometric Blood Pressure Values Are Algorithm-SpecificAmerican Journal of CardiologyVol. 106Issue 10
- PreviewLandgraf et al1 reported “differences” between 2 blood pressure values measured simultaneously in a group of subjects. Their concept is that there is a valid way to compare auscultatory estimates of blood pressure with oscillometric values estimated by an automated monitor. We are all familiar with differences between 2 observers' estimates from simultaneous auscultation of exactly the same K sounds when using a double-headed stethoscope. The concept that there is an “oscillometric blood pressure value” is inherently flawed.
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