Routine blood pressure measurement: application of the standard canine technique in a human.
OBJECTIVE: To examine the effect of applying to human blood pressure readings the standard veterinary method for dogs. DESIGN, SUBJECT AND METHODS: The standard method for dogs uses the mean of five readings after rejection of the initial reading. The canine technique was applied to a human and readings for early morning and afternoon compared on working and non-working days; these values were compared with the single (discarded) reading which started each session. Non-invasive (oscillometric) blood pressure measurements were obtained from the Dinamap 1846 device with printer, set to read automatically at 60 s intervals. RESULTS: The systolic blood pressure was significantly higher on working days, even in the morning, although this would not have emerged from single readings. The diastolic blood pressure was significantly higher during working-day evenings but the heart rate was significantly higher during working mornings. The initial (discarded) reading was significantly higher for systolic but not for diastolic blood pressure. The diastolic results showed greater variation with single readings. Heart rate data did not differ between means and single readings. Systolic and diastolic blood pressures rose significantly during working days but not during non-working days; the heart rate fell during working days. CONCLUSION: Human blood pressure measurements are often based on single readings, even in epidemiological studies. Sensitive monitoring of blood pressure requires a series of readings and allowance for time of day and discrimination between working and non-working days.
Michell
AR
University of London (Royal Veterinary College), Hatfield, UK.