title: How to evaluate BP measurements using the oscillometric method in atrial fibrillation: the value of pulse rate variation.
abstract: An oscillometric device is recommended for blood pressure (BP) measurement in atrial fibrillation (AF), but there is still controversy concerning its accuracy. Therefore, evaluation of BP values in AF patients remains a challenge. This study included 251 patients with AF and 154 participants with sinus rhythm (SR). Pulse rate (PR) and BP were measured using an oscillometric device three times. The differences between the highest and lowest PR and the systolic and diastolic BP (SBP and DBP) were calculated as ΔPR, ΔSBP and ΔDBP, respectively. AF patients were stratified with respect to ΔPR in 0-5, 6-10, 11-15 and >15 subgroups. The AF group had a greater ΔPR (12.1±8.6 vs. 4.10±3.21 b.p.m., P<0.001), ΔSBP and ΔDBP than the SR group at similar SBP and DBP. A positive correlation existed between ΔPR and ΔSBP (r=0.255, P<0.001) in AF patients, but no correlation was found in SR subjects. Meanwhile, the ΔSBP in the 0-5 and 6-10 subgroups (9.58±5.61 and 10.67±6.77 vs. 8.45±5.25 mm Hg, nonsignificant) was similar to the SR group, whereas ΔSBP in the 11-15 and >15 subgroups was significantly greater than the SR group. Regardless of ΔPR, the ΔDBP in the AF group was significantly greater than that of the SR group. The AF patients who exhibited greater variability in their PR also had a greater variability in their SBP readings. The SBP measurement for AF patients is accurate as the measurement for patients with SR if the ΔPR is of 0-10 b.p.m. in AF.
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Xi-Xing
authors.initials: XX
authors.lastname: Wang
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Shuai
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Kui
authors.initials: K
authors.lastname: Hong
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Jinsong
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Ju-Xiang
authors.initials: JX
authors.lastname: Li
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Xiao-Shu
authors.initials: XS
authors.lastname: Cheng
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Su
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000295:instrumentation; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009991:Oscillometry