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• W2313686472 abstract "Background Mercury being an occupational and environmental hazard, health care facilities are lately under significant pressure to replace mercury based equipments. Replacing mercury sphygmomanometers is however problematic, as extreme concern has been raised about the accuracy of the alternative devices. A need to scientifically validate alternate methods of blood pressure measurement was felt. Patients and Methods Blood pressures’ using the Standard mercury Sphygmomanometer, Omron MX 3 oscillometric device and Hawskley random zero sphygmomanometer was measured in 432 individuals at two different points of time. Of the total individuals screened 225 patients were hypertensive, 106 were diabetic as well as hypertensive and 101 individuals were healthy controls. We took 3 readings with each device sequentially, to decrease the bias due to higher values of initial readings; the average of 3 readings was taken as final outcome. The difference of the blood pressure readings between these devices was also compared in different age groups {Group A-18–45(n = 54), Group B-46–65(n = 91), Group C->65 yrs n = 186) and according to severity of hypertension {Group D (SBP <160DBP<100) and Group E (SBP ≥160, DBP≥100)}. Patients were treated according to standard mercury sphygmomanometer readings. Results Among the hypertensive individuals in Group A and B, oscillometric method when compared to the standard mercury sphygmomanometer underestimated both SBP and DBP by a mean difference of −6.63(−12.24 to −1.02, p-0.014) and −7.73 (−10.48 to −4.19, p-0.000) respectively. Similar results were found in hypertensives in Group C (−3.81{−8.12 to −1.21, p-0.201} and-8.61 {−10.8 to −7.06, p-0.001}). In diabetic patients of Group A and B, this method was found to underestimate the SBP by mean difference of −5.31(p-0.611) and DBP by mean difference of −7.46 (p-0.004) with similar results in Group C (SBP −2.51{p-1.0} and DBP −8.568 {p-0.001}). Among the hypertensive patients, this under estimation by oscillometric method was significantly affected by blood pressure level. In Group A/B and C this underestimation increased significantly with severity of hypertension SBP ≥160 mm Hg (p-0.023) and DBP ≥100 (P-0.035) mmHg (according to standard mercury sphygmomanometer). When oscillometric method when compared to the random zero sphygmomanometer method hypertensive individuals of Group A and B, it overestimated the systolic blood pressure by mean difference of 1.07(−4.53 to 6.68, p-1.000) and underestimated diastolic blood pressure by mean difference of −0.97(95% CI −4.11 to 2.17, p-1.000). However in Group C it underestimated the SBP(−3.79 (−10.43 to 2.85,p – 0.51) and the DBP(−11.16 to −5.82,p – 0.0001. The difference in readings for SBP for patients in Group A and B with diabetes and hypertension when compared to healthy individuals revealed a greater difference in diabetics as compared to hypertensives{1.048(−0.930 to 3.028, p-0.608)},the difference was less though nonsignificant when compared to healthy individuals 1.153(−3.526 to 1.218, p-0.726). For diastolic blood pressure the difference in diabetic patient was more as compared to hypertensives and healthy individuals by mean difference of 0.764(−1.344 to 2.872, p-1.000) and 0.624(−3.151 to 1.902, p-1.000) respectively. In Group C for SBP and DBP, this difference was less in hypertensive and diabetic patients as compared to patients with hypertension alone-1.082 (p-0.293), −1.836 (p-0.035). Again in Group A/B and C individuals this underestimation increased significantly with severity of hypertension SBP ≥160 mm Hg (p-0.919) and DBP ≥100 (P-0.086) mmHg (according to standard mercury sphygmomanometer). Conclusions Oscillometric blood pressure measuring device significantly underestimates systolic and diastolic blood pressure as compared to standard mercury sphygmomanometer but it overestimates the systolic blood pressure and underestimates the diastolic blood pressure as compared to the Hawskley random zero sphygmomanometer. We cannot rely on oscillometric device especially for diagnosis of hypertension as this can lead to under diagnosis of hypertension. Since mercury sphygmomanometer are being replaced by oscillometric devices in some countries, so the definition of hypertension may need revision." @default.
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• W2313686472 date "2011-11-01" @default.
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• W2313686472 title "E-003 COMPARISON OF THE BLOOD PRESSURE MONITORING IN HYPERTENSIVE INDIVIDUALS BY OSCILLOMETRIC METHOD WITH HAWKSLEY RANDOM ZERO SPHYGMOMANOMETER AND STANDARD MERCURY SPHYGMOMANOMETER" @default.
• W2313686472 doi "https://doi.org/10.1097/01.hjh.0000408008.64786.10" @default.
• W2313686472 hasPublicationYear "2011" @default.
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