Accuracy of auscultatory blood pressure measurements in hypertensive and obese subjects.

Abstract

SUMMARY In 59 treated or untreated hypertensive subjects and 52 obese subjects (normotensive or hypertensive), intraarterial blood pressure (BP) was compared to simultaneous auscultatory measurements. In the hypertensive group, arm circumference was less than 35 cm compared to over 35 cm in the obese subjects. The occluding cuffs were 12 x 35 cm and 15 x 43 cm respectively. Mean difference between auscultatory and intraarterial systolic BP (SBP) was among the hypertensive -8.8 mm Hg (SD D[FF 9.0 mm Hg, range + 13/ -28) and among the obese -3.1 mm Hg (SD D(FF 13.8 mm Hg, range + 19/-49). Mean difference auscultatory-intraarterial diastolic BP (DBP) Phase V was among the hypertensive patients + 10.8 mm Hg(SD D1FF 6.8 mm Hg, range + 29/-8), and among the obese + 5.5 mm Hg (SD DIFF 7.3 mm Hg, range + 20/-10). Thus, a 15 x 43 cm cuff used in obese subjects with an arm circumference exceeding 35 cm gave quite as reliable measurements as a 12 x 35 cm cuff used in hypertensive subjects with "normal" dimension of the upper arm (< 35 cm). It is emphasized that there is a wide scatter in the interindividual differences, and it is argued that a comparison between auscultatory and intraarterial BP should be performed in patients with poorly controlled hypertension. (Hypertension 5: 122-127, 1983) KEY WORDS • blood pressure • measurement of blood pressure • hypertension • obesity S EVERAL studies have been published concerning the difference between direct (intraarterial) and indirect (auscultatory) measurement of brachial artery blood pressure (BP). 1 " 13 In these studies nearly all the subjects have been normotensive controls, and only a few have been treated or untreated hypertensives. In both obese and nonobese hypertensive subjects, we have compared the auscultatory measurements with simultaneous short-lasting intraarterial values in order to evaluate whether there is an artifact using the conventional cuff technique. The aims of the present study were to compare auscultatory and intraarterial readings in a group of consecutively referred hypertensive subjects, and to evaluate similar comparisons performed among obese subjects (hypertensive and normotensive). Material and MethodsA total of 59 treated or untreated hypertensive patients were investigated (table 1). Before treatment,

Correlation Between the Brachial Blood Pressure Values Obtained Using the Cuff Method and the Central Blood Pressure Values Obtained Invasively

“…For many years, reports have described the discrepancies in blood pressure readings observed between the direct and indirect methods (13)(14)(15)(16). The findings of the present study regarding underestimation of blood pressure by the indirect method are consistent with the findings previously reported by Ochiai (13), Nielsen (15) and others.…”

Assessment of the Accuracy of Indirect Blood Pressure Measurements.

“…A-D, A-D converter. 5 normotensive subjects (4 males and one female), ranging in age from 30 to 73 years (average 48.0 years). Nine of the hypertensive subjects were in stage I of the WHO classification, 12 in stage II, and 8 in stage III.…”

“…[5][6][7] In order to assess the accuracy of indirect blood pressure (BP) measurements, we performed simultaneous recording of indirect measurements with the auscultatory, oscillometric and microphone methods as well as a direct measurement in hypertensive and normotensive subjects, and compared indirectly measured BPs with directly measured ones8) Furthermore, we examined the effect of aging, arterial wall stiffness and blood pressure fluctuation on BP readings.…”

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review

“…27 29 32–34 Only three studies were inside the 95% CIs for the summary receiver operating curve (SROC) summary point. The five outlying studies had a relatively small sample size (5–20 participants).…”