Automated oscillometric blood pressure monitors showed a mean systolic BP difference of -3.0 mmHg (95% CI: -6.58 to 0.59) compared to auscultatory methods in elderly patients with atrial fibrillation.
Systematic Review (n=938)
Does automated oscillometric blood pressure monitoring provide reliable blood pressure measurements compared to standard methods in geriatric patients with atrial fibrillation?
Automated oscillometric blood pressure monitoring provides clinically acceptable blood pressure measurements compared to auscultatory methods in elderly patients with atrial fibrillation, though its accuracy for diastolic BP compared to invasive measurements is less assured.
Mean Difference: -3 (95% CI -6.58–0.59)
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.
Park et al. (Tue,) conducted a systematic review in Atrial fibrillation (n=938). Automated oscillometric blood pressure monitor (AOBPM) vs. Auscultatory BP method was evaluated on Difference in systolic blood pressure (AF-AF group) (MD -3.0, 95% CI -6.58 to 0.59). Automated oscillometric blood pressure monitors showed a mean systolic BP difference of -3.0 mmHg (95% CI: -6.58 to 0.59) compared to auscultatory methods in elderly patients with atrial fibrillation.