Automated blood pressure measurement in special situations: patients with chronic atrial fibrillation or chronic aortic regurgitation.
Fully-automated blood pressure measurement has become increasingly widespread over the last few years, especially in the field of blood pressure self-measurement. The high prevalence of arterial hypertension among the aged (over 30%) means that, frequently, the users additionally suffer from cardiac irregularity and valvular heart disease. Using comparative, invasive blood pressure measurements, we investigated the reliability and accuracy of the currently authorized blood pressure measuring devices, both in patients with the most common cardiac irregularity, atrial fibrillation, and in patients with aortic regurgitation, as an example of blood pressure measurement in connection with hypercirculation. Certain things must be taken into account when carrying out auscultatory blood pressure measurement according to Riva-Rocci and Korotkoff if blood pressure levels are to be determined accurately. Firstly, considering the individual variability of blood pressure levels in connection with atrial fibrillation, the mean value from three consecutive blood pressure measurements is more accurate than a single measurement. Secondly, the diastolic blood pressure of patients with significant aortic regurgitation should always be determined with Phase 4 according to Korotkoff. In patients with atrial fibrillation, the accuracy of the blood pressure devices being considered should be investigated individually. In comparison, devices employing the oscillometric measuring technique for blood pressure self-measurement in the upper arm determine blood pressure levels more accurately and reliably than devices for measurement in the wrist or auscultatory devices. In patients with significant aortic regurgitation, diastolic blood pressure levels determined with currently authorized, fully-automated blood pressure measuring devices are reliable and accurate. Systolic blood pressure levels determined in the upper arm are, however, too high.
Kardiologische Klinik Herzzentrum, Nordrhein-Westfalen, Universitätsklinik, Ruhr-Universität Bochum, Germany.
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Eckert
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Gleichmann
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Gleichmann
D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology*; D015924:Blood Pressure Monitors; D002908:Chronic Disease; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*