Comparison of noninvasive oscillometric and intra-arterial blood pressure measurements in hyperacute stroke

Efstathios Manios, Konstantinos Vemmos, Georgios Tsivgoulis, Gerasimos Barlas, Koroboki Eleni, Konstantinos Spengos, Nikolaos Zakopoulos

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

OBJECTIVES: This study aims to compare automatic oscillometric blood pressure recordings with simultaneous direct intra-arterial blood pressure measurements in hyperacute stroke patients to test the accuracy of oscillometric readings. METHODS: A total of 51 first-ever stroke patients underwent simultaneous noninvasive automatic oscillometric and intra-arterial blood pressure monitoring within 3 h of ictus. Casual blood pressure was measured in both arms using a standard mercury sphygmomanometer on hospital admission. Patients who received antihypertensive medication during the blood pressure monitoring were excluded. RESULTS: The estimation of systolic blood pressure (SBP) using oscillometric recordings underestimated direct radial artery SBP by 9.7 mmHg (95% confidence interval: 6.5-13.0, P<0.001). In contrast, an upward bias of 5.6 mmHg (95% confidence interval: 3.5-7.7, P<0.001) was documented when noninvasive diastolic blood pressure (DBP) recordings were compared with intra-arterial DBP recordings. For SBP and DBP, the Pearson correlation coefficients between noninvasive and intra-arterial recordings were 0.854 and 0.832, respectively. When the study population was stratified according to SBP bands (group A: SBP≤160 mmHg; group B: SBP>160 mmHg and SBP≤180 mmHg, group C: SBP>180 mmHg), higher mean ΔSBP (intra-arterial SBP-oscillometric SBP) levels were documented in group C (+19.8 mmHg, 95% confidence intervals: 12.2-27.4) when compared with groups B (+8.5 mmHg, 95% confidence intervals: 2.7-14.5; P=0.025) and A (+5.9 mmHg, 95% confidence intervals: 1.8-9.9; P=0.002). CONCLUSION: Noninvasive automatic oscillometric BP measurements underestimate direct SBP recordings and overestimate direct DBP readings in acute stroke. The magnitude of the discrepancy between intra-arterial and oscillometric SBP recordings is even more prominent in patients with critically elevated SBP levels.

Original languageEnglish (US)
Pages (from-to)149-156
Number of pages8
JournalBlood Pressure Monitoring
Volume12
Issue number3
DOIs
StatePublished - Jun 1 2007
Externally publishedYes

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Arterial Pressure
Stroke
Blood Pressure
Confidence Intervals
Reading
Sphygmomanometers
Radial Artery
Mercury
Antihypertensive Agents

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialized Nursing

Cite this

Comparison of noninvasive oscillometric and intra-arterial blood pressure measurements in hyperacute stroke. / Manios, Efstathios; Vemmos, Konstantinos; Tsivgoulis, Georgios; Barlas, Gerasimos; Eleni, Koroboki; Spengos, Konstantinos; Zakopoulos, Nikolaos.

In: Blood Pressure Monitoring, Vol. 12, No. 3, 01.06.2007, p. 149-156.

Research output: Contribution to journalArticle

Manios, Efstathios ; Vemmos, Konstantinos ; Tsivgoulis, Georgios ; Barlas, Gerasimos ; Eleni, Koroboki ; Spengos, Konstantinos ; Zakopoulos, Nikolaos. / Comparison of noninvasive oscillometric and intra-arterial blood pressure measurements in hyperacute stroke. In: Blood Pressure Monitoring. 2007 ; Vol. 12, No. 3. pp. 149-156.
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abstract = "OBJECTIVES: This study aims to compare automatic oscillometric blood pressure recordings with simultaneous direct intra-arterial blood pressure measurements in hyperacute stroke patients to test the accuracy of oscillometric readings. METHODS: A total of 51 first-ever stroke patients underwent simultaneous noninvasive automatic oscillometric and intra-arterial blood pressure monitoring within 3 h of ictus. Casual blood pressure was measured in both arms using a standard mercury sphygmomanometer on hospital admission. Patients who received antihypertensive medication during the blood pressure monitoring were excluded. RESULTS: The estimation of systolic blood pressure (SBP) using oscillometric recordings underestimated direct radial artery SBP by 9.7 mmHg (95{\%} confidence interval: 6.5-13.0, P<0.001). In contrast, an upward bias of 5.6 mmHg (95{\%} confidence interval: 3.5-7.7, P<0.001) was documented when noninvasive diastolic blood pressure (DBP) recordings were compared with intra-arterial DBP recordings. For SBP and DBP, the Pearson correlation coefficients between noninvasive and intra-arterial recordings were 0.854 and 0.832, respectively. When the study population was stratified according to SBP bands (group A: SBP≤160 mmHg; group B: SBP>160 mmHg and SBP≤180 mmHg, group C: SBP>180 mmHg), higher mean ΔSBP (intra-arterial SBP-oscillometric SBP) levels were documented in group C (+19.8 mmHg, 95{\%} confidence intervals: 12.2-27.4) when compared with groups B (+8.5 mmHg, 95{\%} confidence intervals: 2.7-14.5; P=0.025) and A (+5.9 mmHg, 95{\%} confidence intervals: 1.8-9.9; P=0.002). CONCLUSION: Noninvasive automatic oscillometric BP measurements underestimate direct SBP recordings and overestimate direct DBP readings in acute stroke. The magnitude of the discrepancy between intra-arterial and oscillometric SBP recordings is even more prominent in patients with critically elevated SBP levels.",
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AU - Manios, Efstathios

AU - Vemmos, Konstantinos

AU - Tsivgoulis, Georgios

AU - Barlas, Gerasimos

AU - Eleni, Koroboki

AU - Spengos, Konstantinos

AU - Zakopoulos, Nikolaos

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N2 - OBJECTIVES: This study aims to compare automatic oscillometric blood pressure recordings with simultaneous direct intra-arterial blood pressure measurements in hyperacute stroke patients to test the accuracy of oscillometric readings. METHODS: A total of 51 first-ever stroke patients underwent simultaneous noninvasive automatic oscillometric and intra-arterial blood pressure monitoring within 3 h of ictus. Casual blood pressure was measured in both arms using a standard mercury sphygmomanometer on hospital admission. Patients who received antihypertensive medication during the blood pressure monitoring were excluded. RESULTS: The estimation of systolic blood pressure (SBP) using oscillometric recordings underestimated direct radial artery SBP by 9.7 mmHg (95% confidence interval: 6.5-13.0, P<0.001). In contrast, an upward bias of 5.6 mmHg (95% confidence interval: 3.5-7.7, P<0.001) was documented when noninvasive diastolic blood pressure (DBP) recordings were compared with intra-arterial DBP recordings. For SBP and DBP, the Pearson correlation coefficients between noninvasive and intra-arterial recordings were 0.854 and 0.832, respectively. When the study population was stratified according to SBP bands (group A: SBP≤160 mmHg; group B: SBP>160 mmHg and SBP≤180 mmHg, group C: SBP>180 mmHg), higher mean ΔSBP (intra-arterial SBP-oscillometric SBP) levels were documented in group C (+19.8 mmHg, 95% confidence intervals: 12.2-27.4) when compared with groups B (+8.5 mmHg, 95% confidence intervals: 2.7-14.5; P=0.025) and A (+5.9 mmHg, 95% confidence intervals: 1.8-9.9; P=0.002). CONCLUSION: Noninvasive automatic oscillometric BP measurements underestimate direct SBP recordings and overestimate direct DBP readings in acute stroke. The magnitude of the discrepancy between intra-arterial and oscillometric SBP recordings is even more prominent in patients with critically elevated SBP levels.

AB - OBJECTIVES: This study aims to compare automatic oscillometric blood pressure recordings with simultaneous direct intra-arterial blood pressure measurements in hyperacute stroke patients to test the accuracy of oscillometric readings. METHODS: A total of 51 first-ever stroke patients underwent simultaneous noninvasive automatic oscillometric and intra-arterial blood pressure monitoring within 3 h of ictus. Casual blood pressure was measured in both arms using a standard mercury sphygmomanometer on hospital admission. Patients who received antihypertensive medication during the blood pressure monitoring were excluded. RESULTS: The estimation of systolic blood pressure (SBP) using oscillometric recordings underestimated direct radial artery SBP by 9.7 mmHg (95% confidence interval: 6.5-13.0, P<0.001). In contrast, an upward bias of 5.6 mmHg (95% confidence interval: 3.5-7.7, P<0.001) was documented when noninvasive diastolic blood pressure (DBP) recordings were compared with intra-arterial DBP recordings. For SBP and DBP, the Pearson correlation coefficients between noninvasive and intra-arterial recordings were 0.854 and 0.832, respectively. When the study population was stratified according to SBP bands (group A: SBP≤160 mmHg; group B: SBP>160 mmHg and SBP≤180 mmHg, group C: SBP>180 mmHg), higher mean ΔSBP (intra-arterial SBP-oscillometric SBP) levels were documented in group C (+19.8 mmHg, 95% confidence intervals: 12.2-27.4) when compared with groups B (+8.5 mmHg, 95% confidence intervals: 2.7-14.5; P=0.025) and A (+5.9 mmHg, 95% confidence intervals: 1.8-9.9; P=0.002). CONCLUSION: Noninvasive automatic oscillometric BP measurements underestimate direct SBP recordings and overestimate direct DBP readings in acute stroke. The magnitude of the discrepancy between intra-arterial and oscillometric SBP recordings is even more prominent in patients with critically elevated SBP levels.

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