Abstract
The objective of the present investigation was to study the effects of a 60-s interval of venous congestion between two noninvasive measurements of arterial blood pressure (ABP) on the fluctuation of ABP, assessed by the standard deviation of the differences between two readings. ABP was measured in 345 successive patients, at rest, four times each. For 269 participants, one pair of readings was obtained with a 60-s interval and the other pair without an interval. For 76 patients, the first pair was read at the same interval, and the second pair had venous congestion interposed and there was no waiting interval. There was no increased ABP oscillation, either when there was no interval between ABP readings, or when venous congestion was interposed compared to pairs of ABP measurements performed with a 60-s interval. There was no increase in ABP oscillations when successive ABP readings were taken without an interval or even with venous congestion interposed. Contrary to the present belief, there seems to be no loss of reliability when blood pressure recordings are taken immediately one after another, in the clinical setting.
Highlights
Hypertension is a leading risk factor for coronary artery disease, congestive heart failure, renal disease and stroke
The recommendation of having an interval of 30 to 60 s between two consecutive arterial blood pressure (ABP) measurements is present in textbooks and even in the guidelines prepared by societies or committees involved in blood pressure and high blood pressure investigation [1,2,3,4,5,6,7,8]
We investigated the effect of venous congestion upon the second reading by comparing two measurements following the recommended time interval with pairs of readings with venous congestion interposed without an additional time interval
Summary
Hypertension is a leading risk factor for coronary artery disease, congestive heart failure, renal disease and stroke. ABP cuff measurement remains the most appropriate screening test for hypertension This method of ABP measurement is prone to errors resulting from instrument, observer and patient factors. When venous congestion is produced, hydrostatic overload develops, triggering the venoarterial cutaneous vasoconstrictor reflex, a physiological reaction that produces a reduction in local flow of about 50% through an increase in vascular resistance caused by vasoconstriction. This reflex consists of constriction of small arteries or arterioles in response to venous distension, probably corresponding to a local axonal reflex situated between a distension vein receptor and a constrictor arterial effector. We investigated the effect of venous congestion upon the second reading by comparing two measurements following the recommended time interval with pairs of readings with venous congestion interposed without an additional time interval
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