-
Blood Pressure Monitoring Feb 2020This study aimed to identify whether automated oscillometric blood pressure monitor (AOBPM) is a reliable blood pressure (BP) measurement tool in geriatric patients with... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This study aimed to identify whether automated oscillometric blood pressure monitor (AOBPM) is a reliable blood pressure (BP) measurement tool in geriatric patients with atrial fibrillation (AF) with high variability in BP and to evaluate whether it can be applied in practice.
METHODS
Electronic searches were performed in databases including MEDLINE, EMBASE, the Cochrane Library, and CINAHL by using the following keywords: 'atrial fibrillation,' 'atrial flutter, 'blood pressure monitor', 'sphygmomanometer.' The QUADAS-2 was applied to assess the internal validity of selected studies. Meta-analysis was performed using RevMan 5.3 program.
DESIGN
Systematic review.
RESULTS
We identified 10 studies, including 938 geriatric patients with AF. We compared with the previously used BP measurement method (mainly office) and AOBPM, and the patients with AF were divided into the AF-AF (atrial fibrillation rhythm continued) and AF-SR groups (sinus rhythm recovered). The difference in the systolic BP was -3.0 mmHg [95% confidence interval (CI): -6.58 to 0.59] and -1.62 (95% CI: -6.08 to 2.84) mmHg in the AF-AF and AF-SR groups, respectively. The difference in the diastolic BP was 0.17 (95% CI: -2.90 to 3.25) mmHg and -0.23 (95% CI: -5.11 to 4.65) mmHg, respectively.
CONCLUSION
This review showed that the BP difference from AOBPM compared with the auscultatory BP method was less than 5 mmHg in the elderly with AF. This difference is acceptable in clinical practice. However, AOBPM compared with invasive arterial BP in the diastolic BP was a difference of 5 mmHg or more, and so its accuracy cannot be assured.
Topics: Aged; Arterial Pressure; Atrial Fibrillation; Blood Pressure Determination; Blood Pressure Monitors; Female; Humans; Male; Oscillometry; Reproducibility of Results
PubMed: 31714346
DOI: 10.1097/MBP.0000000000000414 -
Blood Pressure Monitoring Dec 2019A mercury sphygmomanometer has been considered a gold standard for measuring blood pressure. However, by the Minamata Convention on Mercury, the traditional mercury... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
A mercury sphygmomanometer has been considered a gold standard for measuring blood pressure. However, by the Minamata Convention on Mercury, the traditional mercury sphygmomanometer is being replaced by an automated oscillometric device. This study aimed to provide scientific evidence to determine whether an automated oscillometric device can replace a mercury sphygmomanometer and if it is applicable in routine practice.
METHODS
MEDLINE, EMBASE, the Cochrane Library, and CINAHL were searched on 4 May 2018. Studies comparing blood pressure measurements between automated oscillometric devices and mercury sphygmomanometers were included. Study characteristics were abstracted using the evidence table, and random-effects meta-analyses were conducted.
RESULTS
Data were compiled from 24 studies comprising 47 759 subjects. The results of meta-analysis showed that automated oscillometric devices measured lower than mercury sphygmomanometers for both systolic blood pressure (mean differences -1.75 mmHg, 95% confidence intervals: -3.05 to -0.45, I = 91.0%) and diastolic blood pressure (mean differences -1.20 mmHg, 95% confidence intervals: -2.16 to -0.24, I = 95.0%). In sub-group analyses by manufacturer, BpTRU measured lower than the mercury sphygmomanometer and OMRON showed no difference compared to the mercury sphygmomanometer for both systolic and diastolic blood pressure, but the results differed depending on the devices.
CONCLUSION
As a result of this review, the difference in blood pressure between the mercury sphygmomanometer and the automated oscillometric device was within 5 mmHg, but the heterogeneity between the studies was very high. The automated oscillometric devices showed differences in blood pressure results according to the manufacturer and product type.
Topics: Blood Pressure; Blood Pressure Determination; Humans; Hypertension; Mercury; Oscillometry; Reproducibility of Results; Sphygmomanometers
PubMed: 31658107
DOI: 10.1097/MBP.0000000000000412