Abstract
BackgroundThe aim of our study was to investigate the reliability of automated oscillometric blood pressure (BP) monitoring in the presence and absence of atrial fibrillation (AF) in hypertensive patients.MethodsBP was measured and compared in 71 randomly selected patients with AF and arterial hypertension diagnosis, 4 times each by auscultatory and oscillometric (Microlife BP A6 PC with AF detection system) methods.ResultsStudy included 71 patients: 36 males (mean age 67.4 years) and 35 females (70.2 years). At the time of BP measuring procedure, 36 patients were in sinus rhythm (SR) and 35 in AF. In SR patients mean systolic blood pressure (SBP) was 132 ± 17.9 mmHg with auscultatory method (AM), 137.4 ± 19.4 mmHg with oscillometric method (OM); mean diastolic BP was 77.1 ± 10.9 mmHg (AM), 78.5 ± 12.2 mmHg (OM), in AF patients mean SBP was 127.5 ± 15.1 mmHg (AM), 133.6 ± 17.4 mmHg (OM); mean diastolic BP was 81.4 ± 9.9 mmHg (AM), 83.5 ± 11.8 mmHg (OM), p = 0.037. The averages of differences for SBP and DBP in sinus rhythm group were (−5.3 mmHg (95% limits of agreement −27.2 – 16.6)) and (−1.4 mmHg (95% limits of agreement −12.8 – 10.0)), respectively. In patients with AF the averages of differences for SBP and DBP were (−6.1 mmHg (95% limits of agreement −23.9 – 11.7)) and (−2.1 mmHg (95% limits of agreement −12.9 – 8.7)), respectively.ConclusionsThe oscillometric device validated for patients with AF on average gives 5.3 mmHg higher systolic BP values for patients with SR and 6.3 mmHg higher BP values for patients with AF. However, the limits of agreement between two methods reveal wide range of random error rates which is a questionable topic in clinical practice, as it could possibly affect the treatment of arterial hypertension in patients with AF.
Highlights
The aim of our study was to investigate the reliability of automated oscillometric blood pressure (BP) monitoring in the presence and absence of atrial fibrillation (AF) in hypertensive patients
The only difference was that more patients with sinus rhythm (SR) used ACFI, while more patients with AF were on Calcium-channel blockers (CCBs), thiazide or loop diuretics and more patients with AF were on combined medication (2 or 3 drugs in one tablet)
The results revealed that oscillometric method shows higher negative bias while measuring systolic BP in both (SR and AF) groups to compare with diastolic BP (−5.3 mmHg and −6.1 mmHg versus −1.4 mmHg and −2.1 mmHg, respectively)
Summary
The aim of our study was to investigate the reliability of automated oscillometric blood pressure (BP) monitoring in the presence and absence of atrial fibrillation (AF) in hypertensive patients. Early diagnosis and Šelmytė–Besusparė et al BMC Cardiovascular Disorders (2017) 17:87 patients with AF [13] because the devices measure BP from a smooth profile of successive pressure waves [14] and because of high variability of the heart rate and stroke volume during arrhythmia [15]. Recent systematic review and meta–analysis [18] demonstrated that there is limited evidence in studies that validated the automated BP devices in AF. Meta–analysis concluded that oscillometric devices may be suitable for measuring systolic, but not for diastolic BP and may be appropriate for measuring BP at home, but not for office measurement
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