Auscultatory versus oscillometric measurement of blood pressure in octogenarians

Department of Geriatrics, Odense University Hospital , Denmark.
Blood pressure (Impact Factor: 1.81). 05/2012; 21(5):269-72. DOI: 10.3109/08037051.2012.680751
Source: PubMed


Abstract Background. Auscultatory measurement using a sphygmomanometer has been the predominant method for clinical estimation of blood pressure, but it is now rapidly being replaced by oscillometric measurement. Objective. To compare blood pressure by auscultatory and oscillometric measurements in patients ≥ 80 years. Method. 100 patients had blood pressure measured by auscultation with a sphygmomanometer and by an electronic device using the oscillometric method. For each patient the mean of two blood pressures with each method measured within 15 min were compared. Results. The mean age of participants was 85.8 years; 55.8% were women. The correlation coefficient for systolic blood pressure was 0.88 and for diastolic 0.79. Differences between auscultatory and oscillometric values were less than 10 mmHg in 70.6% of systolic blood pressures and in 83.2% for diastolic. Arrhythmia and hypertension did not influence the results, and there was no correlation between the magnitude of the differences and the level of blood pressure. Conclusion. Agreement between oscillometric and auscultatory measurements of blood pressure in octogenarians was found to be less than required by validation protocols. However, semi-automatic equipment, which is observer-independent, may be used even in the very elderly, particularly if multiple readings are performed.

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    ABSTRACT: The objective of this study was to elucidate the usefulness of both the oscillometric blood pressure (OBP) and auscultatory blood pressure (ABP) measurement technique in the assessment of blood pressure (BP) and target organ damage in the general population. We studied a sample of the Finnish adult population aged 25-74 years. Four hundred and eighty-four study participants underwent a health examination including measurements of 24-h urine albumin, echocardiographic variables of the left ventricle, intima media thickness and pulse wave velocity. OBP and ABP were measured simultaneously four times by beginning the OBP measurements in random order from the right or left arm and by switching the devices between hands after two measurements. The mean OBP was 126.7/77.4 mmHg and the mean ABP was 124.5/78.0 mmHg. Systolic difference between OBP compared with ABP was large in men. Male sex, higher arm circumference and lower systolic BP were independent determinants explaining the greater difference between systolic OBP compared with ABP. Diabetes, higher arm circumference and higher pulse wave velocity were independent determinants explaining greater difference between diastolic OBP compared with ABP. The correlations of target organ damage between OBP and ABP were equally good. At population level OBP and ABP measurements yielded similar results in relation to BP level and the indicators of target organ damage, probably due to the simultaneous and controlled measurement protocol, and to the sample of participants from the general population. It is, however, recommendable to use either OBP or ABP measurements for individual patients to avoid unnecessary interdevice variability.
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