Measuring blood pressure in stable renal transplant recipients: what you measure depends on what you use.
BACKGROUND
Blood pressure levels have a major impact on cardiovascular and renal transplant outcomes after renal transplantation. But there are significant challenges to accurately measure blood pressure levels in stable healthy renal transplant outpatients. We aimed to test whether there are differences in BP measurements taken using either automated oscillometric machines or a random zero sphygmomanometer.


METHODS
Blood pressure was recorded twice in a random order with each of three BP measuring devices (DINAMAP BP8800; OMRON HEM 713 and a Random-Zero Hawskley sphygmomanometer). Results were analysed to determine observer bias, cardiovascular artefacts, and intra- and inter-machine BP variation.


CONCLUSIONS
There was no significant observer bias or cardiovascular artefacts. Intra-machine variability was small. BP measurement using DINAMAP and OMRON could lead to a difference of up to 30 mm Hg higher or 15 mm Hg lower than Hawskley random zero BP readings. Though widely used for 'convenience', oscillometric measures of BP in the renal transplant clinic are not optimal.
Renal and Transplantation Unit, Guy's Hospital, London, UK. wisp101@hotmail.com
Behdad
B
Afzali
Ali A
AA
Haydar
Ian C
IC
Abbs
David J A
DJ
Goldsmith
D000328:Adult; D000368:Aged; D016477:Artifacts; D001331:Automation; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009991:Oscillometry; D015203:Reproducibility of Results; D019722:Sphygmomanometers