Key result
Dynapulse 5000A overestimates systolic blood pressure by ~14 mmHg compared to mercury-Doppler, failing validation criteria.
Why the study?
Does the Dynapulse 5000A ambulatory blood pressure monitor provide accurate and repeatable systolic blood pressure measurements compared to mercury-Doppler in children and young adults?
Cross-Sectional (n=59)
No
Does the Dynapulse 5000A ambulatory blood pressure monitor provide accurate and repeatable systolic blood pressure measurements compared to mercury-Doppler in children and young adults?
The Dynapulse 5000A over-reads systolic blood pressure compared to mercury-Doppler, highlighting significant difficulties and limitations in validating pediatric blood pressure monitors using current BHS guidelines.
Clinicians should not use the Dynapulse 5000A for pediatric BP assessment; leaves open the need for revised validation protocols in children.
The aim of this study was to assess the performance of a new ambulatory blood pressure monitor (Dynapulse 5000A) in children and young adults. The reference methods, i.e. the mercury-Doppler (Hg-D) method of blood-pressure measurement (recommended for less than 5-year-old children by the British Hypertension Society criteria) and the mercury-auscultation (Hg-A) technique (recommended for 5 years and above) were initially compared utilizing 132 concomitant systolic blood pressure (SBP) readings taken among 44 subjects (3 in each) aged 2-30 years. Hg-D over-read SBP above that of the conventional Hg-A by a mean of 5.25 mmHg (95% confidence interval (CI) 4.11, 6.4). This difference in measurement between the two techniques was also significantly (p = 0.01) related to age. [Difference in mmHg = 7.83 (95% CI 5.53, 10.12) -0.30 (95% CI -0.54, -0.07) age in years.] The Dynapulse 5000A was therefore validated only against Hg-D throughout the age range and was undertaken utilizing 468 concomitant resting SBP measurements taken among 59 subjects (supine or sitting) using a 'T' system. The Dynapulse was found to give higher SBP readings (average 13.5 mmHg) than Hg-D sphygmomanometry. Although the differences were not dependent on the age of the child, the pulse rate or the body mass index, there was a significant drift in the differences with time (-0.05 mmHg/day). Repeatability of each of the measurement methods calculated utilizing two or three consecutive recordings taken at 1-min intervals showed that variability between repeated measurements made with the Dynapulse (14.8%) was greater than for Hg-D. Repeatability coefficient of the Hg-D (11.2%) was also less than ideal for a reference method. We conclude that Dynapulse 5000A over-reads SBP above that detected by Hg-D, but cannot be fairly graded by British Hypertension Society criteria due to the inconsistency and poor repeatability of the recommended reference methods.
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Chulananda Goonasekera (1998) conducted a cross-sectional in Children and young adults (n=59). Dynapulse 5000A ambulatory blood pressure monitor vs. Mercury-Doppler (Hg-D) sphygmomanometry was evaluated on Mean difference in systolic blood pressure between Dynapulse 5000A and Mercury-Doppler sphygmomanometry (MD 13.5 mmHg). The Dynapulse 5000A over-read systolic blood pressure by an average of 13.5 mmHg compared to reference mercury-Doppler sphygmomanometry, failing British Hypertension Society criteria.
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