title: Arterial stiffness as underlying mechanism of disagreement between an oscillometric blood pressure monitor and a sphygmomanometer.
abstract: Oscillometric blood pressure devices tend to overestimate systolic blood pressure and underestimate diastolic blood pressure compared with sphygmomanometers. Recent studies indicate that discrepancies in performance between these devices may differ between healthy and diabetic subjects. Arterial stiffness in diabetics could be the underlying factor explaining these differences. We studied differences between a Dinamap oscillometric blood pressure monitor and a random-zero sphygmomanometer in relation to arterial stiffness in 1808 healthy elderly subjects. The study was conducted within the Rotterdam Study, a population-based cohort study of subjects aged 55 years and older. Systolic and diastolic blood pressure differences between a Dinamap and a random-zero sphygmomanometer were related to arterial stiffness, as measured by carotid-femoral pulse wave velocity. Increased arterial stiffness was associated with higher systolic and diastolic blood pressure readings by the Dinamap compared with the random-zero sphygmomanometer, independent of age, gender, and average mean blood pressure level of both devices. The beta-coefficient (95% CI) was 0.25 (0.00 to 0.50) mm Hg/(m/s) for the systolic blood pressure difference and 0.35 (0.20 to 0.50) mm Hg/(m/s) for the diastolic blood pressure difference. The results indicate that a Dinamap oscillometric blood pressure device, in comparison to a random-zero sphygmomanometer, overestimates systolic and diastolic blood pressure readings in subjects with stiff arteries.
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus Medical Center Rotterdam, The Netherlands.
authors.forename: N M
authors.initials: NM
authors.lastname: van Popele
authors.forename: W J
authors.initials: WJ
authors.lastname: Bos
authors.forename: N A
authors.initials: NA
authors.lastname: de Beer
authors.forename: D A
authors.initials: DA
authors.lastname: van Der Kuip
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: J C
authors.initials: JC
authors.lastname: Witteman
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000592:standards*; D015924:Blood Pressure Monitors / Q000592:standards; D015331:Cohort Studies; D004548:Elasticity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000592:standards; D015203:Reproducibility of Results; D017678:Sex Distribution; D019722:Sphygmomanometers / Q000592:standards*