scholarly journals Can blood pressure be measured without undressing patients ?

2021 ◽  
Vol 4 (1) ◽  
pp. 21-29
Author(s):  
Pierre-Yves Durand ◽  
Typhaine Le Hegarat ◽  
Thibault Gutter
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Statistical Significance ◽  
Blood Pressure Measurement ◽  
Winter Season ◽  
Routine Practice ◽  
Dialysis Patients ◽  
Arterial Blood ◽  
The Mean ◽  
The Difference

The guidelines recommend that the technique of measuring arterial blood pressure requires positioning the cuff on a bare arm, without rolled-up sleeve. These recommendations are sometimes difficult to apply in routine practice, as in dialysis centers where the measurement is repeated in fragile patients. In this study, we assess the validity of the blood pressure measurement with a cuff positioned on a bare arm, compared to a cuff positioned on several layers of clothing. A total of 1,224 blood pressure measurements were taken in 51 dialysis patients over a period of one month, 6 measurements per week, i.e. 24 measurements per patient. The patients wore their ordinary clothes suitable for a winter season. Thus, 612 measurements were taken with a cuff on a bare arm, and 612 measurements with a cuff on clothing. The mean systolic pressures were 121.9 and 123.5 mmHg, respectively when the cuff was placed on clothing and bare skin. The mean diastolic pressure was 60.1 and 60.5 mmHg, respectively. The observed difference does not reach the level of statistical significance with respectively p = 0.168 and p = 0.135. The same is true for mean arterial pressure, with 80.6 and 81.5 mmHg respectively (p = 0.142). The difference observed does not justify the undressing of patients for whom this procedure is difficult, uncomfortable or painful.

Indirect Arterial Blood Pressure Measurement in Nonsedated Irish Wolfhounds: Reference Values for the Breed

2002 ◽  
Vol 38 (6) ◽  
pp. 521-526 ◽  
Author(s):  
Janice M. Bright ◽  
Mariellen Dentino
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Reference Values ◽  
Diastolic Pressure ◽  
Blood Pressure Measurement ◽  
Systolic Pressure ◽  
Standing Position ◽  
Mean Value ◽  
Pressure Measurements ◽  
Arterial Blood

Arterial blood pressure measurements were obtained from 158 healthy Irish wolfhounds using the oscillometric technique to establish reference values for the breed. In contrast to other sight hounds, Irish wolfhounds have low arterial blood pressure. Mean systolic pressure for the group was 116.0 mm Hg. Mean diastolic pressure was 69.2 mm Hg, and the mean value for mean arterial pressure was 87.8 mm Hg. Blood pressure measurements were higher in older wolfhounds than in young dogs. There was no difference between systolic and mean arterial blood pressures in lateral recumbency compared to standing position. However, diastolic pressure was slightly lower when standing. Calm dogs had lower pressure than anxious wolfhounds. There was a significant interaction between the effects of age, gender, and mood on systolic, diastolic, and mean arterial blood pressure values.

scholarly journals Automated Versus Manual Blood Pressure Measurement: A Randomized Crossover Trial in the Emergency Department of a Tertiary Care Hospital in Karachi, Pakistan: Are Third World Countries Ready for the Change?

2016 ◽  
Vol 4 (3) ◽  
pp. 404-409 ◽  
Author(s):  
Kanaan Mansoor ◽  
Saba Shahnawaz ◽  
Mariam Rasool ◽  
Huwad Chaudhry ◽  
Gul Ahuja ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
P Value ◽  
Care Hospital ◽  
Pressure Measurements ◽  
The Mean ◽  
The Difference ◽  
Manual Blood Pressure ◽  
Mercury Sphygmomanometer

BACKGROUND: Hypertension has proven to be a strong liability with 13.5% of all mortality worldwide being attributed to elevated blood pressures in 2001. An accurate blood pressure measurement lies at the crux of an appropriate diagnosis. Despite the mercury sphygmomanometer being the gold standard, the ongoing deliberation as to whether mercury sphygmomanometers should be replaced with the automated oscillometric devices stems from the risk mercury poses to the environment.AIM: This study was performed to check the validity of automated oscillometric blood pressure measurements as compared to the manual blood pressure measurements in Karachi, Pakistan.MATERIAL AND METHODS: Blood pressure was recorded in 200 individuals aged 15 and above using both, an automated oscillometric blood pressure device (Dinamap Procare 100) and a manual mercury sphygmomanometer concomitantly. Two nurses were assigned to each patient and the device, arm for taking the reading and nurses were randomly determined. SPSS version 20 was used for analysis. Mean and standard deviation of the systolic and diastolic measurements from each modality were compared to each other and P values of 0.05 or less were considered to be significant. Validation criteria of British Hypertension Society (BHS) and the US Association for the Advancement of Medical Instrumentation (AAMI) were used. RESULTS: Two hundred patients were included. The mean of the difference of systolic was 8.54 ± 9.38 while the mean of the difference of diastolic was 4.21 ± 7.88. Patients were further divided into three groups of different systolic blood pressure <= 120, > 120 to = 150 and > 150, their means were 6.27 ± 8.39 (p-value 0.175), 8.91 ± 8.96 (p-value 0.004) and 10.98 ± 10.49 (p-value 0.001) respectively. In our study 89 patients were previously diagnosed with hypertension; their difference of mean systolic was 9.43 ± 9.89 (p-value 0.000) and difference of mean diastolic was 4.26 ± 7.35 (p-value 0.000).CONCLUSIONS: Systolic readings from a previously validated device are not reliable when used in the ER and they show a higher degree of incongruency and inaccuracy when they are used outside validation settings. Also, readings from the right arm tend to be more precise.

scholarly journals An analysis of blood pressure measurement in a primary care hospital in Swaziland

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Ganizani Mlawanda ◽  
Michael Pather ◽  
Srini Govender
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Good Clinical Practice ◽  
Clinical Decision ◽  
Care Hospital ◽  
Correct Treatment ◽  
Primary Care Hospital ◽  
The Mean ◽  
The Difference ◽  
The Impact

Background: Measurement of blood pressure (BP) is done poorly because of both human and machine errors.Aim: To assess the difference between BP recorded in a pragmatic way and that recorded using standard guidelines; to assess differences between wrist- and mercury sphygmomanometerbased readings; and to assess the impact on clinical decision-making.Setting: Royal Swaziland Sugar Corporation Mhlume hospital, Swaziland.Method: After obtaining consent, BP was measured in a pragmatic way by a nurse practitioner who made treatment decisions. Thereafter, patients had their BP re-assessed using standard guidelines by mercury (gold standard) and wrist sphygmomanometer.Results: The prevalence of hypertension was 25%. The mean systolic BP was 143 mmHg (pragmatic) and 133 mmHg (standard) using a mercury sphygmomanometer; and 140 mmHg for standard BP assessed using wrist device. The mean diastolic BP was 90 mmHg, 87 mmHg and 91 mmHg for pragmatic, standard mercury and wrist, respectively. Bland Altman analyses showed that pragmatic and standard BP measurements were different and could not be interchanged clinically.Treatment decisions between those based on pragmatic BP and standard BP agreed in 83.3% of cases, whilst 16.7% of participants had their treatment outcomes misclassified. A total of 19.5% of patients were started erroneously on anti-hypertensive therapy based on pragmatic BP.Conclusion: Clinicians need to revert to basic good clinical practice and measure BP more accurately in order to avoid unnecessary additional costs and morbidity associated within correct treatment resulting from disease misclassification. Contrary to existing research,wrist devices need to be used with caution.

scholarly journals Measuring the Hemodynamic Flow in the Brachial-Ulnar-Radial Arterial System

2015 ◽  
Vol 23 (3) ◽  
pp. 113-127
Author(s):  
Alexandru M. Morega ◽  
Cristina Săvăstru ◽  
Mihaela Morega
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Measurement ◽  
Applanation Tonometry ◽  
Arterial System ◽  
Structural Deformation ◽  
Arterial Blood ◽  
Arterial Blood Pressure Measurement ◽  
Hemodynamic Flow

Abstract Cardiovascular investigations start with the arterial blood pressure measurement and the easiest and accessible approach takes the recording of the systolic and diastolic pressure levels by a sphygmomanometer, usually during compression of the upper arm, or the wrist (same level as the heart), on the path of the brachial artery. More information on arterial hemodynamic, beyond blood pressure monitoring, could result from investigations based on the pulse wave analysis, like applanation tonometry, which is based on pressure sensed on the arm’s surface, at several observation points along the brachial tree. The reactivity and the accuracy of the sensors depend on their design; capacitive and piezoelectric sensors are good candidates for this task. Based on numerical analysis, the work presented here evaluates the usage of applanation tonometry data for the investigation of hemodynamic parameters and examines some technical and medical aspects of the method. The multiphysics numerical model assembles three different problems: hemodynamic flow, structural deformation of the arm and generation of electricity through deformable sensors.

scholarly journals Comparison of Doppler ultrasonic and oscillometric devices (with or without proprietary optimisations) for non-invasive blood pressure measurement in conscious cats

2020 ◽  
pp. 1098612X2093240
Author(s):  
Petra Cerna ◽  
Panos E Archontakis ◽  
Hester OK Cheuk ◽  
Danièlle A Gunn-Moore
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Reference Intervals ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Arterial Blood ◽  
Oscillometric Device ◽  
Significant Difference ◽  
Systolic Arterial Blood Pressure ◽  
The Mean

Objectives This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. Methods Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer’s guidelines. Doppler and oscillometric devices were used alternately as the first device. Results Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A ( P <0.001) and B ( P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A ( P = 0.002) and B ( P <0.001). Both modes’ MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (–14.94 mmHg), with a smaller bias and narrower LOA. Conclusions and relevance The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.

Cardiovascular Hemodynamics Consequence to Crossed Circulation in the Dog

1958 ◽  
Vol 192 (2) ◽  
pp. 345-352 ◽  
Author(s):  
W. J. Roberson ◽  
Steven M. Horvath
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cardiac Output ◽  
Carotid Artery ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Diastolic Pressure ◽  
Recovery Period ◽  
Arterial Blood ◽  
The Mean

Twelve experiments were conducted on anesthetized and paired dogs of similar weights subjected to unimpeded, unregulated crossed circulation. Shunts were made between the carotid arteries and external jugular veins and free flow allowed for 60 minutes or longer. Statistically significant changes occurred in the mean femoral arterial blood pressures, carotid shunt blood flow, heart rate, cardiac output, cardiac work, percentage of cardiac output flowing through the shunt and pulmonary systolic and diastolic pressures of one or both animals from their control values. The mean arterial blood pressure remained at control levels for several minutes and then dropped precipitously to hypotensive levels. The lowest mean pressures between 42 and 49 mm Hg occurred within the first 16.5 minutes of the open shunt phase with a gradual return toward control levels. The volume of blood flowing through the shunt was increased initially 250% above the control carotid blood flow, followed by a reduction in flow after 15 minutes; the volume flow at this moment was still double precross circulation levels. A secondary increase in the shunt blood flow occurred throughout the remainder of the open shunt phase. In general, the heart rates and peripheral vascular resistance were slightly elevated during the open shunt phase while cardiac output and work decreased below their control values. A marked and similar increase in the percentage of the cardiac output flowing through the carotid artery was observed in both animals. During the 60 minutes of the recovery period mean arterial blood pressure, cardiac output and work tended to return to control levels while the carotid artery blood flow and pulmonary systolic and diastolic pressure remained slightly below their control values.

Reliability of single office blood pressure measurements

Heart ◽  
2018 ◽  
Vol 104 (14) ◽  
pp. 1173-1179 ◽  
Author(s):  
Thilo Burkard ◽  
Michael Mayr ◽  
Clemens Winterhalder ◽  
Licia Leonardi ◽  
Jens Eckstein ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Office Blood Pressure ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Short Term ◽  
Cross Sectional ◽  
Registration Number ◽  
The Mean ◽  
The Difference

ObjectivesStandard operating procedures for office blood pressure measurement (OBPM) vary greatly between guidelines and studies. We aimed to compare the difference between a single OBPM and the mean of the three following measurements. Further, we studied how many patients with possible hypertension may be missed due to short-term masked hypertension (STMH) and how many might be overdiagnosed due to short-term white coat hypertension (STWCH).Design and settingIn this cross-sectional, single-centre trial, 1000 adult subjects were enrolled. After 5 min of rest, four sequential standard OBPMs were performed at 2 min intervals in a quiet room in sitting position. We compared the first (fBPM) to the mean of the second to fourth measurement (mBPM). STMH was defined as fBPM <140 mm Hg systolic and <90 mm Hg diastolic and mBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg. STWCH was defined as fBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg and mBPM <140 mm Hg systolic and <90 mm Hg diastolic.ResultsComplete measurements were available in 802 subjects. Between fBPM and mBPM, 662 (82.5%), 441 (55%) and 208 (25.9%) subjects showed a difference in systolic and 531 (66.2%), 247 (30.8%) and 51 (6.4%) in diastolic blood pressure (BP) values of >2 mm Hg, >5 mm Hg and >10 mm Hg, respectively. In 3.4% of initially normotensives STMH and in 34.3% of initially hypertensives, STWCH was apparent.ConclusionsThere are significant differences between a single OBPM and the mean of consecutive BP measurements. Our study provides evidence that a single OBPM should not be the preferred method and should be discouraged in future guidelines.Trial registration numberNCT02552030;Results.

Noninvasive measurement of systolic and diastolic blood pressure in swine

1982 ◽  
Vol 242 (1) ◽  
pp. H127-H130 ◽  
Author(s):  
B. C. Hodgkin ◽  
D. E. Burkett ◽  
E. B. Smith
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Doppler Ultrasound ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Ulnar Artery ◽  
Arterial Blood ◽  
Significant Difference ◽  
Sample Correlation ◽  
The Difference

Arterial blood pressure was measured noninvasively using Doppler ultrasound and an occluding cuff. The subjects were 28 domestic pigs (10-49 kg) anesthetized with pentobarbital sodium (25 mg/kg). Indirect pressure measurements were made with the Doppler unit placed over the radial or the ulnar artery proximal to the carpal joint. Comparison was made with directly measured pressure to determine the reliability and reproducibility of the indirect method. Direct systolic pressures between 73 and 230 mmHg and diastolic pressures between 52 and 165 mmHg were measured. There was no significant difference between directly and indirectly measured systolic pressure (P greater than 0.20). Indirectly measured diastolic pressure tended to be lower than direct diastolic pressure, the difference by the paired t test being significant to P = 0.06. For systolic pressure the sample correlation coefficient was 0.94, and for diastolic pressure, 0.88. Both systolic and diastolic blood pressure can be accurately measured in the anesthetized pig using Doppler ultrasound and an occluding cuff.

Validation of blood pressure measurement by the complex for daily monitoring of ECG and blood pressure “Medicom-Combi" by oscillometric and auscultatory methods in pediatric population (according to the BHS-93 protocol)

2021 ◽  
pp. 75-78
Author(s):  
I. G. Moreno
Keyword(s):  
Blood Pressure ◽  
Pediatric Population ◽  
Blood Pressure Measurement ◽  
Oscillometric Method ◽  
Daily Monitoring ◽  
Auscultatory Method ◽  
The Mean ◽  
The Difference ◽  
Study Participants ◽  
Sequential Measurements

Purpose. To assess the accuracy of blood pressure (BP) measurement by the complex for daily monitoring of ECG and blood pressure «MedicomCombi» in comparison with a mercury sphygmomanometer in pediatric patients.Materials and methods. The recruitment of study participants was carried out in accordance with the criteria outlined in the international protocol BHS-93 for the pediatric population. During the tests, repeated sequential measurements of blood pressure were carried out by experts (using mercury sphygmomanometers) and the tested complex (by oscillometric and auscultatory methods).Results. The mean SBP, determined by the oscillometric method, was 116.0 ± 13.6 mm Hg, DBP - 69.0 ± 11.8 mm Hg. The mean SBP according to the auscultatory method was 116.0 ± 14.6 mm Hg, DBP - 70.4 ± 11.9 mm Hg. In 66% of cases for SBP and in 62% of cases for DBP, the difference between expert and test measurements by the oscillometric method did not exceed 5 mm Hg. In 100% of cases for SBP and in 96% of cases for DBP, the differences were within 10 mm Hg. The average differences between the experts and the tested complex were - 0.2 ± 5.7 mm Hg for SBP and 1.6 ± 6.1 for DBP. In 68 % of cases for SBP and in 65 % of cases for DBP, the difference between expert and test measurements by the auscultatory method was no more than 5 mm Hg. In 100% of cases for SBP and in 95% of cases for DBP, the differences did not exceed 10 mm Hg. The average differences between the experts and the tested complex were - 0.3 ± 4.7 mm Hg for SBP and 0.1 ± 5.7 for DBP.Conclusion. The complex for daily monitoring of ECG and blood pressure «Medicom-Combi» has demonstrated compliance with the accuracy requirements specified in the BHS 1993 protocol (class «А/А»), and can be recommended for measuring blood pressure by oscillometric and auscultatory methods in pediatric practice.

scholarly journals PERBANDINGAN TEKANAN DARAH ANTARA ANAK YANG TINGGAL DI PEGUNUNGAN DAN PESISIR PANTAI

e-CliniC ◽  
2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Queen Mandang ◽  
Adrian Umboh ◽  
Stefanus Gunawan
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Sodium Intake ◽  
Blood Pressure Measurement ◽  
Systolic Pressure ◽  
Coastal Areas ◽  
Cross Sectional ◽  
The Difference ◽  
Cross Sectional Design ◽  
History Of Obesity

Abstract: Blood pressure in children varies because there are many factors that influence. One is geographic factors. Based on data from the Health Research in 2007 found that the prevalence of hypertension is highest in coastal areas while the lowest prevalence of hypertension in the coastal area. Altitude and different sodium intake on mountain and coastal areas are assumed to affect the blood pressure. This study aimed to determine the difference in blood pressure between children who live in the mountains and in the coast. We used descriptive analytic method with cross sectional design, with 107 samples according to criteria of children aged 6-12 years with no family history of obesity and hypertension. Data were obtained by using questionnaire, measurement of weight and height (BMI) and blood pressure measurement using a sphygmomanometer and cuff child. The results showed 15.5% of children with high-normal systolic pressure and 17.4% of children with high diastolic pressure in the mountains. In coastal areas, found 28% of children with normal systolic pressure-high, 13% of children of normal-high diastolic pressure, and 5% of children of high diastolic pressure. These data were analyzed using Mann Whitney test, showing the results were not statistically significantly systolic (p = 0.815) diastolic (p = 0.221) so that H0 and H1 is rejected. Conclusion: There was no difference in blood pressure among children aged 6-12 years who live in the mountains and the coast.Keywords: child's blood pressure, mountains, coastal.Abstrak: Tekanan darah pada anak bervariasi karena ada banyak faktor yang memengaruhi. Salah satunya adalah faktor geografis. Berdasarkan data Riset Kesehatan Dasar tahun 2007 didapatkan prevalensi hipertensi tertinggi di wilayah pantai sedangkan prevalensi hipertensi terendah di wilayah pantai. Ketinggian lokasi dan asupan natrium yang berbeda pada daerah pegunungan dan pesisir pantai diasumsikan berpengaruh terhadap tekanan darah. Penelitian ini bertujuan untuk mengetahui perbedaan tekanan darah antara anak yang tinggal di pegunungan dan pesisir pantai. Metode penelitian deskriptif analitik dengan rancangan potong lintang, dengan 107 sampel sesuai kriteria anak umur 6-12 tahun tanpa obesitas dan riwayat keluarga hipertensi. Data diperoleh melalui kuesioner, pengukuran berat badan dan tinggi badan (IMT) dan pengukuran tekanan darah menggunakan sphygmomanometer dan manset anak. Hasil penelitian menunjukkan 15,5% anak dengan tekanan sistolik normal-tinggi dan 17,4% anak dengan tekanan diastolik tinggi pada daerah pegunungan. Pada daerah pesisir pantai ditemukan 28% anak dengan tekanan sistolik normal-tinggi, 13% anak tekanan diastolik normal-tinggi, dan 5% anak tekanan diastolik tinggi. Data ini dianalisis menggunakan uji mann whitney, menunjukkan hasil secara statistik tidak bermakna sistolik (p=0,815) diastolik (p=0,221) sehingga H0 diterima dan H1 ditolak. Simpulan: Tidak ada perbedaan tekanan darah antara anak berumur 6-12 tahun yang tinggal di pegunungan dan pesisir pantai.Kata kunci: tekanan darah anak, pegunungan, pantai.

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