Field testing in Suriname of two blood pressure-measuring devices for low-resource and middle-resource countries, according to a WHO protocol

INTRODUCTION: High blood pressure (BP) is known to be the greatest modifiable risk factor of cardiovascular diseases, of which 80% occur in low-resource and middle-resource settings. Yet, BP measurement in these countries remains extremely poor. In 2005, a WHO committee invited manufacturers to produce devices especially for use in low-resource settings. Our study assesses the accuracy, performance, and acceptability of two submitted oscillometric devices under field circumstances in Suriname (South America), namely, the Microlife BP 3AS1-2 and Omron HEM-SOLAR. METHODS: We compared BP measurements of test devices using a conventional Mercury sphygmomanometer, performed by local healthcare workers under field circumstances. Three hundred and forty-two individuals were included. Statistics included t-tests, analysis of variance, and Bland-Altman plots. RESULTS: The mean systolic/diastolic BP differences (SD) were -3.5 (8.0)/-7.0 (6.0) for Omron versus Mercury and -6.4 (7.8)/-6.5 (6.0) mmHg for Microlife versus Mercury. Microlife was more accepted by healthcare workers, and both devices performed adequately under field conditions. DISCUSSION AND CONCLUSION: The acceptability, durability, and performance of both test devices were adequate. However, Microlife BP 3AS1-2 underestimated systolic pressure almost twice as much compared with Omron HEM-SOLAR, with identical diastolic underestimations. Guaranteed global availability, users could make a choice between the Omron HEM-SOLAR being more accurate in BP measurement, and Microlife BP 3AS1-2 being more accepted by healthcare workers.