Comparison of Aneroid and Oscillometric Blood Pressure Measurements in Children

Abstract

Limited data exist on the comparison of blood pressure (BP) measurements using aneroid and oscillometric devices. The purpose of the study was to investigate the difference in BP obtained using oscillometric and aneroid BP monitors in 9-to 10-year-old children. A total of 979 children were divided into group O, which underwent two oscillometric BP readings followed by two aneroid readings, and group A, which had BP measured in the reverse order. No significant difference was found between the mean (AEstandard deviation) of the two systolic BP readings obtained using the oscillometric and aneroid devices (111.5AE8.6 vs 111.3AE8.1 mm Hg; P=.39), whereas the mean diastolic BP was lower with the oscillometric monitor (61.5AE8.0 vs 64.5AE6.8 mm Hg; P<.001). A significant downward trend in BP was observed with each consecutive measurement, and agreement between the two monitors was limited. Multiple BP measurements are, therefore, recommended before the diagnosis of elevated BP or hypertension is made with either method. J Clin Hypertens (Greenwich). 2013;15:776-783. ª2013 Wiley Periodicals, Inc.Measurement of blood pressure (BP) is an essential component of physical examination in both children and adults. In spite of a low prevalence of hypertension in children, 1-4 early and accurate detection of elevated BP is nonetheless very important for preventing future end-organ damage. [5][6][7] While normative data on BP in children are based on manual BP readings using mercury sphygmomanometer, automated oscillometric BP monitors are now widely used in pediatric clinics and hospitals.8 Studies comparing oscillometric and mercury BP monitors have yielded inconsistent findings where the oscillometric method has been found to either overestimate or underestimate the BP. 9-13Two recent US studies 14,15 have investigated the difference between BP measurements obtained by aneroid and mercury sphygmomanometers in children and found no or minimal difference between these measurement methods. To date, the only published study comparing an aneroid sphygmomanometer with an oscillometric BP monitor was carried out in a population of 235 children with chronic kidney disease (CKD). 16 The oscillometric monitor was found to overestimate both the systolic and diastolic BP and limited agreement was found between the two methods in classification of BP status.Although mercury sphygmomanometers have been widely replaced with aneroid BP devices, no studies have compared aneroid sphygmomanometers and automated oscillometric BP monitors in population-based samples. The aim of this study was to compare BP measurements obtained using aneroid sphygmomanometer and automated oscillometric device and to analyze factors contributing to the differences between these two methods in 9-to 10-year-old Icelandic school children. METHODSThe study was a part of a population-based, crosssectional study of BP in healthy 9-to 10-year-old Icelandic school children carried out in the year 2009. 4 Of the 1472 children invited to participate, the parents of 10...

Incident Cardiovascular Disease Among Adults With Blood Pressure <140/90 mm Hg

“…Previous studies have reported only small differences in BP measured by aneroid and oscillometric methods. 38, 39 However, BP measured in the home may be lower compared with BP measured in the clinic. 40 Therefore, we determined the proportion of incident events that occurred among REGARDS study participants with SBP < 135 mm Hg and DBP < 85 mm Hg.…”

Predicting Hypertension Among Children With Incident Elevated Blood Pressure

“…The use of different BP measurement devices across sites also could have negatively affected external validity, as aneroid and oscillometric devices are known to yield different BP measurements within the same subject. 31 Experience measuring BPs in children could vary depending on the clinical setting (e.g. primary care versus specialty care), which could have affected BP accuracy.…”

Blood pressure (BP) assessment—from BP level to BP variability

“…This problem is of particular relevance in very young children for whom 20-40 % of BP measurements may be unreliable (Table 1). Repeated BP measurements should be performed with the same BP device as there is limited agreement between the oscillometric (automated) and aneroid (manual) monitors in terms of detecting an elevated BP; the difference is relatively small for systolic BP (SBP: mean difference=+0.18 mmHg; range −21 to +21 mmHg) but is quite significant for the diastolic BP (DBP: mean difference=−3.1 mmHg; range −33 to +35 mmHg) [10]. These differences are due to the underlying principle of the oscillometric measurement, in which the BP device measures the mean arterial pressure (MAP) directly, whereas both SBP and DBP are calculated by the BP device software proprietary to the device manufacturer, with the consequence that the SBP/DBP are subject to possible variations between various manufacturers.…”