Short report: An outline of the revised British Hypertension Society protocol for the evaluation of blood pressure measuring devices

O’Brien, Eoin; Petrie, J. C.; Littler, W. A.; Swiet, Michael de; Padfield, P L; Altman, Douglas G.; Bland, Martin; Coats, Andrew J.S.; Atkins, Neil

doi:10.1097/00004872-199306000-00013

Cited by 417 publications

(317 citation statements)

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“…Subjects were selected from a general practice database (AAHMeditel) in three equal groups with previous systolic BPs in the ranges shown in Table 1. These are the ranges given in the BHS validation protocol, 7,8 though not as a requirement and not forming any part of the calculations. Having selected equal numbers of patients in this way, they were then put into a single group for the purposes of the investigation and their previous BPs were not used in any subsequent calculations.…”

Section: Methodsmentioning

confidence: 99%

“…One of two observers carried out the tests but since observer error was not an issue, it was not necessary to use the schedule of observer assessment described in instrument validation tests. 7,8 Means of systolic and diastolic values using 'M' and 'L' cuffs were calculated and the differences between these means compared by paired sample ttests and 95% confidence intervals using SPSS.…”

Section: Methodsmentioning

confidence: 99%

“…4 Current official British and United States recommendations are that a 12-cm cuff is suitable for all adult arms. 5,6 The British Hypertension Society's (BHS) protocol for the validation of sphygmomanometers, 7,8 applying mainly to ambulatory devices, uses the BSI recommendation that the bladder of the cuff should encircle 80% of the arm circumference and that the bladder should be changed for obese arms. The American Advancement of Medical Instrumentation (AAMI) document, 6 though not published in a scientific journal, makes similar recommendations.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of normal and large sphygmomanometer cuffs using the Omron 705CP

et al. 2001

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Sphygmomanometers are usually sold with a single cuff though some are supplied with a short cuff as standard and offer a longer one for larger arms. However, data on the differences in measurements taken with different cuffs applied to different sized arms are conflicting and this study set out to investigate the difference between those taken with 'normal' and 'large' cuffs in arms 28 cm or more in circumference. We avoided observer error by using a semi-automatic digital sphygmomanometer, the Omron 705CP. The 22 subjects employed were selected from one general practice as having a range of previous office blood pressures and a variety of arm sizes above 28 cm in circumference. Omron 'normal' and 'large'

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of normal and large sphygmomanometer cuffs using the Omron 705CP

et al. 2001

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“…Clinic BP was measured in one study visit by two physicians who fulfilled the British Hypertension Society Protocol criteria for agreement among observers in BP measurement. 22 Triplicate BP measurements were performed after 5 min sitting rest and with at least 1 min between recordings, using standard mercury sphygmomanometers (inflatable bladder size 9Â18, 12Â24 or 15Â35 cm according to the individuals' arm circumference) and the average was used in the analysis. Clinic hypertension was defined as CBP systolic and/or diastolic X95th percentile using the existing normative data.…”

Section: Bp Measurementsmentioning

confidence: 99%

Relationship of home blood pressure with target-organ damage in children and adolescents

et al. 2011

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The objective of this study was to compare home blood pressure (HBP) vs. ambulatory (ABP) and clinic (CBP) measurements in terms of their association with target-organ damage in children and adolescents. A total of 81 children and adolescents (mean age 13±3 years, 53 boys) referred for elevated CBP had measurements of CBP (1 visit), HBP (6 days) and ABP (24-h). Seventy-six participants were also assessed with carotid-femoral pulse wave velocity (PWV) and 54 with echocardiography. Average CBP was 122.1 ± 15.1/71 ± 12.9 mm Hg (systolic/diastolic), HBP 121.3 ± 11.5/69.4 ± 6.6 mm Hg and 24-h ABP 118.9 ± 12/ 66.6 ± 6.1 mm Hg. Left ventricular mass (LVM) was correlated with systolic blood pressure (BP) (coefficient r¼0.55/0.54/0.45 for 24-h/daytime/nighttime ABP, 0.53 for HBP and 0.41 for CBP; all Po0.01). No significant correlations were found for diastolic BP. PWV was also significantly correlated with systolic BP (r¼0.52/0.50/0.48 for 24-h/daytime/nighttime ABP, 0.50 for HBP and 0.47 for CBP; all Po0.01). Only diastolic ABP and HBP were significantly correlated with PWV (r¼0.30 and 0.28, respectively, Po0.05). In multivariate stepwise regression analysis (with age, gender, body mass index [BMI], clinic, home and 24-h ambulatory systolic/diastolic BP and pulse pressure, clinic, home and 24-h heart rate as independent variables), PWV was best predicted by systolic HBP (R 2 ¼0.22, beta ± s.e. ¼0.06 ± 0.01), whereas LVM was determined (R 2 ¼0.67) by 24-h pulse pressure (beta¼1.21±0.41), age (beta¼2.93±1.32), 24-h heart rate (beta¼À1.27±0.41) and BMI (beta¼1.78±0.70). These data suggest that, in children and adolescents, ABP as well as HBP measurements appear to be superior to the conventional CBP measurements in predicting the presence of subclinical end-organ damage.

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“…Validation procedures, eg edited by AAMI 1 or by CE 2 , ensure that on average the systolic and diastolic differences between the two methods do not exceed 5 ± 8 mm Hg. In the British Hypertension Society (BHS) 3 protocol the standard deviation is usually smaller but may also be higher if the mean error is close to zero. An instrument passes this procedure if 50% of the differences are smaller than 5 mm Hg, 75% smaller than 10 mm Hg and 90% smaller than 15 mm Hg.…”

mentioning

confidence: 99%