A Comparison of Direct and Indirect Blood-Pressure Determinations

Roberts, L.; Smiley, Josiah; Manning, George W.

doi:10.1161/01.cir.8.2.232

Cited by 117 publications

(22 citation statements)

References 3 publications

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“…Waugh et al [29], showed in a UK study that 28% of mercury and 42% of aneroid sphygmomanometers were inaccurate by more than T 4 mmHg. In general, cuff sphygmomanometers usually underestimate systolic and overestimate diastolic pressure [30,31], and thus the reverse errors simulated in the present study are more likely to be apparent in clinical practice.…”

Section: Discussionmentioning

confidence: 60%

Transmission of calibration errors (input) by generalized transfer functions to the aortic pressures (output) at different hemodynamic states

Papaioannou¹,

Lekakis²,

Karatzis³

et al. 2006

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 60%

Transmission of calibration errors (input) by generalized transfer functions to the aortic pressures (output) at different hemodynamic states

Papaioannou¹,

Lekakis²,

Karatzis³

et al. 2006

International Journal of Cardiology

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“…It has been known for more than fifty years that there are considerable differences between cuff measurements of brachial pressure and invasive measures, especially in older subjects [15][16][17][18][19][20]. Finnegan et al [17] in one such study involving a volunteer group of 57 subjects (mean age 68.6 years) found that on average cuff pressure significantly underestimated systolic pressure by 5 mmHg compared with catheter measurements, while diastolic brachial cuff pressure was 8 mmHg higher.…”

Section: Discussionmentioning

confidence: 99%

Estimation of central aortic pressure by SphygmoCor® requires intra-arterial peripheral pressures

et al. 2003

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Central arterial pressure, measured close to the heart, may be of more patho-physiological importance than conventional non-invasive cuff blood pressure. The technique of applanation tonometry using SphygmoCor has been proposed as a non-invasive method of estimating central pressure. This relies on mathematically derived generalized transfer functions, which have been previously validated using invasive peripheral pressure measurements. We compared simultaneous estimates of central aortic pressure using this technique with those measured directly during the routine diagnostic cardiac catheterization of 30 subjects (age range 27-84 years), half of whom were aged 65 years or more. This was done by applanating the left radial artery and recording the non-invasive brachial cuff blood pressure to generate a central aortic pressure estimate, using the SphygmoCor radial transfer function. The comparative results were analysed using Bland-Altman plots of mean difference. SphygmoCor, on average, underestimated systolic central arterial pressure by 13.3 mmHg and overestimated diastolic pressure by 11.5 mmHg. The results were similar in patients aged under and above 65 years. Furthermore, non-invasively measured brachial pressures were seen to give an overall closer estimate of the central arterial pressure than the SphygmoCor system. The transfer function has been validated from invasively measured arterial pressures and the current use by the system of non-invasive measures may explain the discrepancies. However, age, drugs and arterial disease would also be expected to play a role.

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“…30,31 The range of discrepancies is quite striking: One author commented that the difference between the 2 methods might be as much as 25 mm Hg in some individuals. 32 There has been disagreement in the past as to whether phase IV or V of the Korotkoff sounds should be used for recording diastolic pressure, but phase IV tends to be even higher than phase V when compared against the true intra-arterial diastolic pressure and is more difficult to identify than phase V. There is now general consensus that the fifth phase should be used, except in situations in which the disappearance of sounds cannot reliably be determined because sounds are audible even after complete deflation of the cuff, for example, in pregnant women, patients with arteriovenous fistulas (eg, for hemodialysis), and aortic insufficiency.…”

Section: The Auscultatory Method-mercury Aneroid and Hybrid Sphygmomentioning

confidence: 99%

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Pickering¹,

Hall²,

Appel³

et al. 2005

Hypertension

2,040

963

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Abstract-Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

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A Comparison of Direct and Indirect Blood-Pressure Determinations

Cited by 117 publications

References 3 publications

Transmission of calibration errors (input) by generalized transfer functions to the aortic pressures (output) at different hemodynamic states

Transmission of calibration errors (input) by generalized transfer functions to the aortic pressures (output) at different hemodynamic states

Estimation of central aortic pressure by SphygmoCor® requires intra-arterial peripheral pressures

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

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