Key result
Standard cuff blood pressure measurement diagnosed diastolic hypertension in 31.25% of subjects versus 8.33% with intra-arterial measurement, yielding a poor specificity of 75%.
Why the study?
Does blood pressure measurement with a standard cuff reliably diagnose diastolic hypertension compared to intra-arterial pressure measurement?
Cross-Sectional (n=48)
Does blood pressure measurement with a standard cuff reliably diagnose diastolic hypertension compared to intra-arterial pressure measurement?
Effect estimate: Specificity 75%
Absolute Event Rate: 31.25% vs 8.33%
Standard cuff blood pressure measurement has poor specificity compared to intra-arterial measurement, which may lead to considerable over-diagnosis of mild hypertension.
Cuff measurements may overdiagnose diastolic hypertension; leaves open the need for larger validation studies against intra-arterial references.
This study compares blood pressures measured with a standard cuff (rubber bag 12 x 35 cm) with concomitantly measured intra-arterial pressures in 48 subjects. With the standard cuff, and using a diagnostic cut-off limit for diastolic hypertension of 90 mmHg, 15/48 patients were found to be hypertensive, whereas only 4/48 had intraarterial pressure above 90 mmHg. Thus, the specificity of the non-invasive method was only 75%. If higher diagnostic cut-off limits were used, e.g. 95 mmHg, specificity increased to 84%, and with lower cut-offs specificity was 63% for 85 mmHg and 52% for 80 mmHg. A specificity of only 75% is very poor for a method commonly used in screening examinations and may lead to considerable over-diagnosis of mild hypertension.
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Stolt et al. (1992) conducted a cross-sectional in Hypertension (n=48). Standard cuff blood pressure measurement vs. Intra-arterial pressure measurement was evaluated on Diagnosis of diastolic hypertension (>90 mmHg) (Specificity 75%). Standard cuff blood pressure measurement diagnosed diastolic hypertension in 31.25% of subjects versus 8.33% with intra-arterial measurement, yielding a poor specificity of 75%.
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