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October 1, 2011Blood Pressure Monitoring

Errors of oscillometric blood pressure measurement as predicted by simulation

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Key result

In a computer-based simulation, induced errors in systolic, diastolic, and mean arterial pressures were 15, 14, and 27 mmHg, respectively, strongly influenced by pulse pressure and arterial stiffness.

Population

Computer-based simulator modeling a variety of arterial pressure pulses of different shapes and amplitudes

Comparison

Modification of the shape of the artery-cuff… vs Normal artery parameters

Design

Other

Authors

RRRein RaamatUniversity of TartuJTJaak TaltsUniversity of TartuKJK. JagomägiUniversity of Tartu

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Implication

May cause substantial oscillometric BP errors in stiff arteries; leaves open need for clinical validation before practice change.

Key Points

  • To evaluate physiological and arterial factors that influence the measurement accuracy of automated oscillometric blood pressure monitoring.
  • Simulated arterial pressure pulses across varied shapes and amplitudes using a computer model to generate cuff volume oscillations under altered artery-cuff pressure-volume relationships.
  • Estimated systolic and diastolic pressures using fixed characteristic ratios and mean arterial pressure using the maximum oscillation criterion across 32 parameter combinations.
  • The simulated conditions induced maximum absolute errors of 15 mmHg for systolic pressure, 14 mmHg for diastolic pressure, and 27 mmHg for mean arterial pressure.
  • Increased pulse pressure shifted systolic values toward underestimation and diastolic values toward overestimation.
  • Arterial stiffening systematically overestimated systolic pressure and increased mean arterial pressure errors proportionally with pulse pressure and pulse steepness.

Structured PICO

P
Population
Computer-based simulator modeling a variety of arterial pressure pulses of different shapes and amplitudes
E
Exposure
Modification of the shape of the artery-cuff pressure/volume relationship and arterial pressure pulses (32 combinations of four affecting factors)
C
Comparator
Normal artery parameters
O
Outcome
Errors in systolic, diastolic, and mean arterial pressuressurrogate

Oscillometric blood pressure readings are strongly influenced by pulse pressure, arterial stiffness, and the shape of the artery-cuff pressure/volume curve, leading to potentially significant measurement errors.

Cite This Study

Raamat et al. (2011) studied Blood pressure measurement accuracy. Pulse pressure, arterial stiffening, and artery-cuff pressure/volume curve shape was evaluated on Errors in systolic, diastolic, and mean arterial pressures. In a computer-based simulation, induced errors in systolic, diastolic, and mean arterial pressures were 15, 14, and 27 mmHg, respectively, strongly influenced by pulse pressure and arterial stiffness.

synapsesocial.com/papers/6a7bef69169fe1af7cc29761https://doi.org/10.1097/mbp.0b013e32834af752
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A mathematical study of some biomechanical factors affecting the oscillometric blood pressure measurement1996 · 179 citations
  2. 2Model-based error analysis of the oscillometric fixed-ratio blood pressure measurement method2012 · 6 citations
  3. 3Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model2012 · 178 citations
  4. 4Accuracy of some algorithms to determine the oscillometric mean arterial pressure2012 · 20 citations
  5. 5The Effects of Brachial Arterial Stiffening on The Accuracy of Oscillometric Blood Pressure Measurement: A Computational Model Study2012 · 10 citations