Oscillometric Blood Pressure Measurement Research Articles

Validation of the Omron HBP-9031C professional office blood pressure monitor in the general population according to the ANSI/AAMI/ISO 81060-2:2013 protocol.

The present study aimed to evaluate the accuracy of the Omron HBP-9031C automated oscillometric upper-arm blood pressure (BP) measurement device for professional office BP monitoring, according to the ANSI/AAMI/ISO 81060-2:2013 protocol (ANSI/AAMI/ISO) in the general population. The device was assessed by using it on 85 participants, who fulfilled our inclusion criteria involving the ranges of arm circumference and systolic and diastolic BP. The validation and data analysis were performed as per the protocol. In the ANSI/AAMI/ISO 81060-2:2013 validation procedure (criterion 1), the mean ± SD of the differences between the test device and reference BP was 1 ± 8/-2 ± 6 mmHg (systolic/diastolic). The mean differences between the two observers and the Omron HBP-9031C were 1 ± 7 mmHg for systolic BP and -2 ± 6 mmHg for diastolic BP, according to criterion 2. The two ANSI/AAMI/ISO criteria were fulfilled. The OMRON HBP-9031C professional BP monitor fulfilled the requirements of the ANSI/AAMI/ISO validation standard and can be recommended for clinical use.

The impact of atrial fibrillation on accuracy of oscillometric blood pressure measurement: effect of ventricular rate.

This study evaluated the impact of ventricular rate (VR) in atrial fibrillation (AF) patients with oscillometric BP measurements. This study included 138 patients with AF and 112 patients with sinus rhythm (SR) who underwent coronary angiography. Left arm BP was measured three times with an oscillometric device, and the average was recorded as the final oscillometric value. At the same time, the average of three intra-aortic BP readings was used as invasive values. Delta BP was the difference between intra-aortic and oscillometric BP. Meanwhile, the BP percentage difference (PD-BP) was calculated with the following formula: PD-BP = (delta BP/intra-aortic BP) × 100%. Based on the VR, four subgroups of AF and SR patients, <80, 80-99, 100-120, and >120 bpm, were created, and the mean PD-BP for both systolic blood pressure (SBP) and diastolic blood pressure (DBP) was significantly higher in the AF group than in the SR group. Moreover, the mean PD-SBP values gradually increased as VR increased in both groups. More importantly, the difference in PD-SBP between the AF and SR groups increased as VR increased: when VR was <80 bpm, the levels were similar (-2.0 ± 3.5 vs. -1.4 ± 2.7 mm Hg, NS), but these values in AF patients were significantly higher when VR was 80-99 bpm (-3.7 ± 5.0 vs. -1.8 ± 2.3 mm Hg, p < 0.05), 100-120 bpm (-6.1 ± 4.3 vs. -2.3 ± 1.9 mm Hg, p < 0.05) and >120 bpm (-7.8 ± 4.9 vs. -2.9 ± 1.7 mm Hg, p < 0.05). The accuracy of oscillometric BP measurements are dependent on the ventricular rate in AF patients even after three measurements, and a higher ventricular rate may result in larger underestimations of oscillometric BP.

P60 Invasive Validation of Antares, a New Algorithm to Calculate Central Blood Pressure from Oscillometric Upper Arm Pulse Waves

BackgroundAntares is an algorithm for pulse wave analysis (PWA) by oscillometric blood pressure monitors in order to estimate central (aortic) blood pressure (cBP). Antares aims to enable brachial cuff-based blood pressure (BP) monitors to be type II-devices, determining absolute cBP values independently of potential peripheral BP inaccuracies. The present study is an invasive validation of the Antares algorithm.MethodsWe followed entirely the 2017 ARTERY protocol for validation of non-invasive cBP devices, the 2013 ANSI/AAMI/ ISO 81060-2 and 2018 AAMI/ESH/ISO validation standard protocols. In total, 191 patients undergoing cardiac catheterization were included, of which 145 patients entered analysis. Invasive cBP recordings were prospectively compared to simultaneous non-invasive cBP estimations using Antares, integrated into an oscillometric BP monitor. Antares analyses pulse waves during deflation of the cuff (patent of Redwave Medical GmbH). Generally speaking, pulse waves of a normal oscillometric BP measurement are taken for PWA with no need for altering standard BP pump operation.ResultsMean difference between invasive and non-invasively estimated systolic cBP was 0.71 mmHg with standard deviation of 5.95 mmHg, fulfilling the highest validation criteria. Bland-Altman plot reveals good limits of agreement.ConclusionAntares is the first algorithm for estimation of cBP that entirely fulfills the 2017 ARTERY and AAMI/ESH/ISO validation protocols including criteria for high accuracy devices. The Antares algorithm turns the oscillometric upper arm blood pressure monitor into a type II-device for estimation of true cBP. Integration of Antares into BP monitors could enable the measurement of PWA parameters in virtually every practice in future.Bland altman of estimated vs. invasive central SBP

UNATTENDED AUTOMATED OFFICE BLOOD PRESSURE MEASUREMENT. DOES IT DIFFER FROM OFFICE BLOOD PRESSURE? INSIGHT FROM A RANDOM POPULATION SAMPLE

Objective: Currently, there is an ongoing controversy about the magnitude of the difference between unattended automated office blood pressure (AOBP) and conventional office blood pressure (BP) measurement. Thus, the aim of our study was to compare AOBP with both mercury sphygmomanometer and oscillometric BP measurements in a random population sample. Design and method: In 2588 subjects of the Czech post-MONICA study (a randomly selected 1% representative population sample aged 25–64 years, mean age 48 ± 11 years, 47.5% males), BP was measured using an AOBP device (BpTRU) unattended, and office BP using a manual mercury sphygmomanometer (Baumanometer) and a validated oscillometric device (Microlife). Results: On average, sphygmomanometer BP was 10.7/5.5 mmHg higher than AOBP. Similarly, oscillometric BP was 10.2/3.6 mmHg higher than AOBP (p < 0.001 for both differences), while the mean difference of 0.5/1.9 mmHg between sphygmomanometer and oscillometric BP was not significant. The difference between sphygmomanometer and AOBP systolic increased nonlinearly with increasing sphygmomanometer BP up to the value of 150 mmHg to remain stable afterwards, while the difference decreased with increasing age and male gender. AOBP systolic of 127 mmHg corresponded to sphygmomanometer systolic BP of 140 mmHg. Similarly, AOBP systolic of 128 mmHg corresponded to an oscillometric value of 140 mmHg. Conclusions: Unattended systolic BP measured using an AOBP device is on average 10 mmHg lower than the office sphygmomanometer or oscillometric value, but the difference is dependent on current BP. The implication is that AOBP values cannot be used interchangeably with other office measurements.

Feasibility of Fingertip Oscillometric Blood Pressure Measurement: Model-Based Analysis and Experimental Validation.

The most commonly used oscillometric upper-arm (UA) blood pressure (BP) monitors are not convenient enough for ambulatory BP monitoring, given the large size of the arm cuff and the compression of UA during the measurement. Finger-worn oscillometric BP devices featuring miniaturized finger cuff have been developed and researched as an alternative solution to the UA-based measurement, yet the reliability of the finger-based measurement is still questioned. To investigate the feasibility of oscillometric BP measurements at the finger position, we performed model-based analysis and experimental validation to explore the underlying issues associated with extending the cuff-based oscillometric approach from UA to other alternative sites. The simulation results revealed that a larger bone-to-tissue volume ratio produced a lower pressure transmission efficiency, which can account for the inter-site measurement discrepancies of mean blood pressure (MBP). We also experimentally compared the oscillometric MBP measurements at UA, middle forearm, wrist, finger proximal phalanx, and finger distal phalanx (FD) of 20 young adults, and each position was matched with a cuff of appropriate size and kept at the same height with the heart. The experimental results demonstrated that FD could be a superior alternative position for oscillometric BP measurement, as it requires the smallest cuff size while providing the most consistent MBP with the UA. Our analysis also suggested that further study is demanded to identify the appropriate oscillometric algorithm for reliable systolic blood pressure and diastolic blood pressure measurements at FD.

Validity of transit time-based blood pressure measurements in patients with and without heart failure or pulmonary arterial hypertension across different breathing maneuvers.

Pulse transit time (PTT) derived by ECG and plethysmographic signal can be a promising alternative to invasive or oscillometry-based blood pressure (BP) monitoring in sleep laboratories because it does not cause arousals from sleep. Therefore, this study assessed the validity of PTT for BP monitoring under sleep laboratory-like conditions. Ten volunteers (55.8 ± 19.6years), 12 patients with heart failure with reduced ejection fraction (HFrEF; 67.3 ± 8.6years), and 14 patients with Nizza class I pulmonary arterial hypertension (PAH; 59.5 ± 13.4years) performed different breathing patterns to simulate nocturnal sleep-disordered breathing (SDB). BP was measured at least every 15min over 1h using oscillometry (Task Force Monitor™) and PTT (SOMNOscreen™) devices in free breathing conditions and during SDB simulation (alternating phases of hyperventilation and apneas). One hundred forty-two points of measurements were collected. No difference was found in both mean systolic BP (SBP) and diastolic BP (DBP) between oscillometric PTT-based BP measurements in the whole population and throughout the whole recording (SBP 111.3 ± 15.1mmHg versus 110.0 ± 14.7mmHg, p = 0.051; DBP 69.9 ± 12.2 versus 69.9 ± 14.2mmHg, p = 0.701). Likewise, no significant difference in SBP and DBP was found between the two methods in the subgroups of healthy subjects, HFrEF patients and PAH patients, both in free breathing conditions (p > 0.05) and during SDB simulation (p > 0.05). When monitoring BP in healthy subjects, and in patients with HFrEF or PAH, PTT provides a BP estimation comparable with oscillometric measurement, though slightly inaccurate, both in the condition of regular and unstable breathing.

Effect of Diminazene aceturate treatment on some cardiovascular parameters and antioxidant status of apparently healthy horses

IntroductionApart from being a widely used antiprotozoal drug in many parts of Africa, Diminazene aceturate (DIZE), has been shown to have beneficial effects in experimental murine models of hypertension, pulmonary hypertension, myocardial infarction, stroke, atherosclerosis, type 1 diabetes, and eye disease. In this study, we investigated the effect of diminazene aceturate treatment after a single intramuscular administration on some cardiovascular parameters and antioxidant status in apparently healthy Nigerian horses.Materials and methodsTen male horses were divided into two groups comprising 5 horses each. Group A was the control group with no drug administered. Group B was treated with DIZE at 3.5 mg/kg, single dose. Baseline data were collected before the commencement of the experiment and thereafter, post‐administration at 0hrs, 24hrs, 48hrs and 96hrs. Base apex electrocardiogram was recorded using a computer ECG machine while oscillometric blood pressure measurement was recorded using a veterinary blood pressure monitor. Markers of oxidative stress were determined in the serumResultSingle intramuscular treatment caused a significant (p&lt;0.05) increase in the systolic, diastolic and mean arterial blood pressure values when compared with the controls. From the electrocardiogram, sinus rhythm was recorded in both groups however, significant (p&lt;0.05) increase in heart rate, p‐wave duration, QRS complex duration and QTc were observed in the treated group when compared with the control. Oxidative stress markers (malondialdehyde and hydrogen peroxide) significantly (p&lt;0.05) increased while antioxidant enzymes (catalase, glutathione peroxidase and glutathione) were decreased when compared to the control.ConclusionThis study indicates that the use of DIZE in horses should be with great caution because of the associated cardiovascular physiological alterations, reduction in activities of antioxidant enzymes and increase in markers of oxidative stress.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Oscillometric measurement of blood pressure: a simplified explanation. A technical note on behalf of the British and Irish Hypertension Society

Oscillometric measurement of blood pressure: a simplified explanation. A technical note on behalf of the British and Irish Hypertension Society

Ambulatory Blood Pressure Monitoring: Profiles in Chronic Kidney Disease Patients and Utility in Management.

Optimal control of blood pressure (BP) may reduce the risk of progression of CKD. Misclassification of hypertension (HTN) and status of control may result in suboptimal management. Clinic or home BP may overestimate or underestimate status of control compared with ambulatory BP monitoring (ABPM), which is considered the gold standard. The latter relates not only to the superiority of ABPM concerning outcome prognosis but also to its ability to accurately diagnose white coat and masked HTN, which is critical in assuring adequate BP control. However, ABPM has not gained widespread use in practice because of limited third-party reimbursement and a paucity of high quality randomized controlled intervention studies evaluating its use. Herein, we review HTN phenotypes that have been identified in patients with CKD, and the potential value of ABPM in this high-risk population.

Dempster–Shafer Fusion Based on a Deep Boltzmann Machine for Blood Pressure Estimation

We propose a technique using Dempster–Shafer fusion based on a deep Boltzmann machine to classify and estimate systolic blood pressure and diastolic blood pressure categories using oscillometric blood pressure measurements. The deep Boltzmann machine is a state-of-the-art technology in which multiple restricted Boltzmann machines are accumulated. Unlike deep belief networks, each unit in the middle layer of the deep Boltzmann machine obtain information up and down to prevent uncertainty at the inference step. Dempster–Shafer fusion can be incorporated to enable combined independent estimation of the observations, and a confidence increase for a given deep Boltzmann machine estimate can be clearly observed. Our work provides an accurate blood pressure estimate, a blood pressure category with upper and lower bounds, and a solution that can reduce estimation uncertainty. This study is one of the first to use deep Boltzmann machine-based Dempster–Shafer fusion to classify and estimate blood pressure.

Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients.

BackgroundStage 5 chronic kidney disease patients on haemodialysis (HD) often present with dizziness and pre-syncopal events as a result of the combined effect of HD therapy and cardiovascular disease. The dysregulation of blood pressure (BP) during orthostasis may be implicated in the aetiology of falls in these patients. Therefore, we explored the relationship between baroreflex function, the haemodynamic responses to a passive orthostatic challenge, and falls in HD patients.MethodsSeventy-six HD patients were enrolled in this cross-sectional study. Participants were classified as “fallers” and “non-fallers” and completed a passive head up tilting to 60o (HUT-60°) test on an automated tilt table. ECG signals, continuous and oscillometric BP measurements and impedance cardiography were recorded. The following variables were derived from these measurements: heart rate (HR) stroke volume (SV), cardiac output (CO), total peripheral resistance (TPR), number of baroreceptor events, and baroreceptor effectiveness index (BEI).ResultsThe forty-four participants who were classified as fallers (57.9%) had a lower number of baroreceptor events (6.5±8.5 vs 14±16.7, p = .027) and BEI (20.8±24.2% vs 33.4±23.3%, p = .025). In addition, fallers experienced a significantly larger drop in systolic (-6.4±10.9 vs -0.4±7.7 mmHg, p = .011) and diastolic (-2.7±7.3 vs 1.8±6 mmHg, p = .027) oscillometric BP from supine to HUT-60° compared with non-fallers. None of the variables taken for the analysis were significantly associated with falls in multivariate logistic regression analysis.ConclusionsThis cross-sectional comparison indicates that, at rest, HD patients with a positive history of falls present with a lower count of baroreceptor sequences and BEI.Short-term BP regulation warrants further investigation as BP drops during a passive orthostatic challenge may be implicated in the aetiology of falls in HD.

NOVEL METHOD FOR ASSESSING ARTERIAL STIFFNESS BASED ON OSCILLOMETRIC BLOOD PRESSURE MEASUREMENT

Arterial stiffness is a major contributor to cardiovascular diseases. The aim of this study is to explore the physiological significance of the brachial mechanical parameters, which could be estimated from oscillometric blood pressure (BP) measurement, and investigate on the potential of these arterial parameters as an index of arterial stiffness. The mechanical characteristics of brachial artery were modeled based on the collapsible tube theory, which includes two important parameters to describe the compliance of brachial artery. After the model validation, the arterial parameters were estimated from the measured oscillometric envelope of 56 subjects by solving an inverse problem. The physiological significance of these parameters was explored by analyzing their association with pulse wave velocity (PWV) as well as with the BP. Arterial compliance parameters were successfully estimated from the envelope of the oscillometric pulse wave in the BP measurement. The parameters were found to be linearly associated with age, PWV, and BP. These results suggest that our method may provide a potential approach to assess arterial compliance based on oscillometric measurement of BP.

Associations Between Characteristics of Obstructive Sleep Apnea and Nocturnal Blood Pressure Surge.

Research suggests that oxygen desaturation and sleep stage during obstructive sleep apnea (OSA) are related to the magnitude of high blood pressure (BP) in a laboratory setting. However, in a clinical setting, these associations have not been well studied. We used a noninvasive oscillometric BP measurement device to investigate the association between oxygen-triggered BP levels at the end of each OSA episode and the characteristics of the preceding OSA episode. In 42 newly diagnosed OSA patients (average age, 63.5±12.5 years; average apnea-hypopnea index, 32.6±18.2 per hour), 258 BP measurements were obtained at the end of OSA episodes. Hypoxia-peak systolic BP (SBP), defined as the maximum oxygen-triggered SBP value, was significantly higher in rapid eye movement sleep (144.9±19.9 mm Hg) than in non-rapid eye movement stage 1 sleep (129.5±15.1 mm Hg; P<0.001) and non-rapid eye movement stage 2 sleep (129.4±14.7 mm Hg; P<0.001). In a multivariate-linear mixed model, the lowest oxygen saturation percentage during each OSA episode was associated with increased hypoxia-peak SBP (-0.501 mm Hg; P<0.001), nocturnal SBP surge (-0.395 mm Hg; P<0.001), defined as the difference between the hypoxia-peak SBP and the mean nocturnal SBP, and maximum value of SBP surge (-0.468 mm Hg; P<0.001), defined as the difference between the hypoxia-peak SBP and the minimum nocturnal SBP independent of sleep stage. These values were not associated with the duration of each OSA episode. The contribution of rapid eye movement sleep and severe oxygen desaturation to OSA-related BP elevation measured with a noninvasive oscillometric method was determined in a clinical setting.

A15480 Pattern of Inter-arm difference in blood pressure and ankle-brachial index in building construction workers

Objectives: Inter-arm blood pressure difference (IAD) has received increased attention recently since it has been found to be associated with peripheral vascular disease (PAD). An inter-arm difference in blood pressure of less than 10mmHg is classified as normal based on the new clinical guideline for hypertension. The ankle-brachial index (ABI) is the ratio of the systolic blood pressure at the ankle compared with the brachial artery pressure. When the ABI is ≤ 0.9, a diagnosis of PAD is made upto a 90% accuracy. Oscillometric blood pressure measurement is commonly used for screening and follow-up monitoring of arterial hypertension, may also used as automated tools for simplified ABI-measurements rather than pinpoint detection of a vessel by a Doppler probe. The purpose of present study is to see the pattern of inter-arm difference in blood pressure and also validate oscillometric ABI measurement by assessing and comparing the results with the current gold standard of Doppler assisted measurement of ABI in building construction workers Methods: Inter-arm difference in blood pressure and ABI was measured in 50 building construction workers with age group between 20- 40 years using Automated Oscillometric device Microlife watchBP office (model- Twin200 AFS), Switzerland with appropriate cuff size for arm and leg circumference. Doppler ABI measurements were made with a commercially available HI-dop (BT-200 vascular Doppler in all building construction workers. Results: Increased systolic inter-arm difference was present in significant number of participants. Oscillometric measurement of ABI was performed significantly faster than Doppler-assisted ABI. Conclusion: In primary care setting, blood pressure should be actively measured in both arms. Oscillometric ABI is feasible and operator- independent.

Do Changes in Hemodynamic Parameters Depend Upon Length of Sleep Deprivation? Comparison Between Subjects With Normal Blood Pressure, Prehypertension, and Hypertension.

The main objective of the study was to analyze the impact of sleep deprivation upon hemodynamic and autonomic parameters in subjects with normal blood pressure (BP) compared to prehypertension and hypertension at 24, 28, and 32 h of total sleep deprivation (TSD). Thirty volunteers, healthy men with current medical tests indicating the absence of disease took part in the study. After physical examination (basic neurological, clinical examination, echocardiography and doppler ultrasound of the renal arteries, evaluation of the autonomic nervous system) subjects were divided into three groups: I – normotensive, II – pre-hypertensive, III – hypertensive (age: 31.2 ± 2.1 vs. 33.5 ± 2.7 vs. 36.8 ± 2.7 years, p > 0.05; BMI: 25.2 ± 0.8 vs. 29.0 ± 1.5 vs. 26.4 ± 1.0 kg/m2, p > 0.05). Hemodynamic and autonomic parameters were automatically measured at rest and in a tilted position with a Task Force Monitor. The Task Force Monitor consists of electrocardiography, impedance cardiography, oscillometric, and continuous BP measurement. Mixed models with random effects was applied in order to analyze the parameters’ dependence on the time and the group of patients. One-way ANOVA or Kruskal–Wallis test were used to detect differences between normotensive, pre-hypertensive and hypertensive groups in each time point. In the pre-hypertensive group 28-h TSD resulted in increased vagal outflow [changes in high frequency heart rate (HR) variability, p = 0.0189], as evidenced by decreased HR (p = 0.0293). Moreover after 24-h TSD and 28-h TSD we observed changes in BP parameters. In hypertensive group, the most important changes in hemodynamic parameters: systolic blood pressure (sBP, p = 0.0031), diastolic blood pressure (dBP, p = 0.0136), cardiac output (CO, p = 0.0439) and changes in HR (p = 0.0063) after tilt test were observed after 32-h TSD. In conclusion, our results show that changes in hemodynamic parameters during sleep deprivation depend on the baseline BP and duration of TSD. What is important, both groups reported a decrease of sBP and dBP during the TSD (pre-hypertensive group after 24, 28-h TSD; hypertensive group after 32-h TSD. In our opinion, this is the first study which considers three homogenous groups in terms of gender: only men, during different points of acute TSD: 24, 28, and 32 h of TSD in laboratory condition.

Effect of anticipation and cuff inflation on blood pressure during self-measurement.

Self-measurement of blood pressure (BP) is increasingly being used for the diagnosis of hypertension and to monitor BP at home. Whenever compared with ambulatory BP measurements, home BP values are frequently higher and less predictive for incident cardiovascular events. We hypothesized that this could be caused by a pressor response elicited by the self-measurement of BP. A total of 50 patients (mean age 62.0 ± 11.2 years, 44% women) were included, 25 with and 25 without at least 10/5 mmHg higher home BP compared with daytime ambulatory BP. All patients performed 10 consecutive oscillometric BP measurements after 10 min of rest, followed by another resting period of 10 min, while continuously monitoring BP and central hemodynamics using finger photoplethysmography. Baseline BP before the start of the self-measurements was compared with the average BP during the first 10 s of inflation of the cuff. In both groups, we observed a significant increase in SBP and DBP during cuff inflation. The mean rise in average BP was 6.9 ± 6.3/4.5 ± 4.3 mmHg in the group with and 4.4 ± 9.4/2.7 ± 5.3 mmHg in the group without a BP difference between home and daytime ambulatory BP compared with baseline, whereas the maximum increase in average BP was 17.4/8.4 mmHg and 17.7/7.5 mmHg (P < 0 01). The increase in BP coincided with an increase in heart rate and cardiac output. BP differences attenuated after multiple readings, but did not disappear. Our results support the existence of a pressor response during self-BP measurement that remains present after multiple BP readings.

Cuff challenges in blood pressure measurement.

The characteristics of the optimal cuff for blood pressure (BP) measurement are still the subject of much debate. The choice of the appropriate cuff in obese individuals depends not only on the arm circumference but also on its shape because a conically shaped arm makes it difficult to fit the cuff to the arm. When a large-size cylindrical cuff is used in conical arms, an overestimation of the true BP is likely to occur with BP discrepancies that may be as large as 10mmHg. With the advent of automatic oscillometric devices, the choice of the appropriate cuff became even more controversial because with oscillometric BP measurement the reference point is not the artery occlusion but the oscillometric peak signal. To overcome the problem of miscuffing in obese individuals, special cuffs that can accommodate a wide range of arm sizes have been designed. Using these cuffs, accurate oscillometric BP measurements can be obtained over a wide range of arm circumferences using a unique software algorithm. These wide-range cuffs coupled to oscillometric devices may represent a good option for BP measurement in very obese subjects. However, their reliability should be confirmed in larger populations and different settings.

The prevalence of elevated blood pressure in a sample of slovene children and adolescents: a pilot study

IntroductionThe aim of our study was to determine the prevalence of prehypertensive and elevated blood pressure in the hypertensive range (elevated BP) and obtain some anthropometric measures in Slovene children and adolescents.MethodsIn the cross-sectional study lasting one year, we measured BP using mercury sphygmomanometers, as well as height, weight, waist, and hip circumferences in schools. Data from regular check-ups (oscillometric measurements) were also added to increase the sample size. Participants were 2-19 years old. For statistical analysis, we used two-sided multivariate analysis of variance, Pearson’s r, and chi-squared test.ResultsFrom altogether 1594 participants, 723 (45.4%) were boys and 871 (54.6%) girls. The prevalence of elevated BP on a single oscillometric blood-pressure measurement was 12.0% (95% CI: 10.3 to 13.9), and an additional 13.9% (95% CI: 12.0 to 15.9) had prehypertensive BP. In Riva-Rocci measurements, elevated BP was present in only 7.1% (95% CI: 4.9 to 10.1) and prehypertensive BP additionally in 3.9% (95% CI: 2.4 to 6.4) in comparison to oscillometric measurements, which showed higher prevalence. Importantly, overweight participants had a 1.75 times greater relative risk for prehypertensive BP (95% CI: 1.22 to 2.53; p<0.01). Obesity carried a 1.79 times greater relative risk (95% CI: 1.22 to 2.63; p<0.01) for BP outside of the normotensive BP range.ConclusionArterial hypertension is becoming an important public health problem, especially due to the childhood obesity. It seems to concern also Slovene young population with prevalence of elevated BP at around 7.1% after a single auscultatory BP measurement.

Accuracy of oscillometric blood pressure measurement in atrial fibrillation.

The primary aim of this study was to assess the accuracy of automated oscillometry (AO) in outpatients with atrial fibrillation (AF). The secondary aim was to explore whether AO accuracy is influenced by beat-to-beat blood pressure (BP) variability or heart frequency (HF). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by AO and beat-to-beat BP using a validated Volume Clamp Method (VCM) technique. AO accuracy was analyzed separately in tertiles of beat-to-beat BP variability and HF. The main study included 58 AF and 38 sinus rhythm (SR) patients in whom the Welch Allyn Spot Vital Signs (WASVS) was used. An auxiliary study in 23 AF patients used the Philips M3002A IntelliVue ×2. For AF and SR patients, respectively, SBP by WASVS deviated by +0.1 (±14.8) mmHg and -7.9 (±15.7) mmHg from VCM. WASVS-DBP was higher than VCM in AF and SR by 6.3 (±9.2) mmHg and 5.0 (±7.7) mmHg, respectively. High beat-to-beat BP variability and high HF decreased WASVS accuracy for both SBP and DBP. SBP and DBP measurements by Philips M3002A IntelliVue ×2 deviated by -6.8 (±13.2) mmHg and 9.4 (±8.1) mmHg, respectively. Overall, AO accuracy in AF is limited; in individual patients, AO inaccuracy may be considerable. AO accuracy is especially reduced in patients showing large beat-to-beat BP variability or high HF.

Deep Boltzmann Regression With Mimic Features for Oscillometric Blood Pressure Estimation

Oscillometric blood pressure (BP) devices are among the standard automatic monitors, now readily available for the home, office, and hospital. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) are obtained at fixed ratios of the envelope of the maximum amplitude of the oscillometric wave signal. However, these fixed ratios can cause overestimation or underestimation of the real SBP and DBP in oscillometric BP measurements. In this paper, we propose a new regression technique using a deep Boltzmann regression with mimic features based on the bootstrap technique to learn the complex nonlinear relationships between the mimic features vectors acquired from the oscillometric signals and the target BPs. The performance of the proposed model is compared with those of conventional and auscultatory techniques. Our regression model with mimic features provides lower standard deviation of error, mean error, mean absolute error, and standard error of estimates than the conventional techniques, along with a similar fit for the SBP and DBP.