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A Meta-analysis to Determine the Validity of Taking Blood Pressure Using the Indirect Cuff Method

  • Scott J. Dankel
  • Minsoo Kang
  • Takashi Abe
  • Jeremy P. LoennekeEmail author
Guidelines, Clinical Trials, and Meta-Analysis (William J. Kostis, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Guidelines/Clinical Trials/Meta-Analysis

Abstract

Purpose of Review

The purpose of this meta-analysis was to compare the magnitude of systematic bias (mean difference) and random error (standard deviation of mean difference) between the cuff method of indirect blood pressure and directly measured intra-arterial pressure.

Recent Findings

Blood pressure is almost exclusively assessed using the indirect cuff method; however, numerous individual studies have questioned the validity relative to directly measured intra-arterial blood pressure.

Summary

PubMed, SportsDiscus, and Scopus were searched through February 2018. Data were analyzed using a random effects model. A total of 62 studies met the inclusion criteria for quantitative analysis including 103 effect sizes for systolic and 114 effect sizes for diastolic blood pressure. Indirect measures of systolic blood pressure were underestimated (− 4.55 (95% CI = − 5.58 to − 3.53) mmHg), while diastolic blood pressure was overestimated (6.20 (95% CI = 5.09 to 7.31) mmHg). The random error (SD units) was 10.32 (95% CI = 9.29 to 11.36) for systolic and 7.92 (95% CI = 7.35 to 8.50) for diastolic blood pressure which corresponds to an estimation accuracy (95% confidence) of ± 20.2 mmHg for systolic blood pressure and ± 15.5 mmHg for diastolic blood pressure. These data indicate that it may be difficult to accurately estimate intra-arterial blood pressure using the cuff method. These results not only have implications for clinicians in diagnosing hypertension, but also may detail a potential underestimation of the association between blood pressure and numerous other health outcomes found in epidemiological studies.

Keywords

Artery Cardiovascular Diastolic Systolic Hypertension 

Abbreviations

AAMI

American Association for the Advancement of Medical Instrumentation

BHS

British Hypertension Society

CI

Confidence interval

ES

Effect size

Notes

Author Contributions

JPL and TA designed the study. SJD extracted the data for analysis. SJD analyzed the data. SJD drafted the initial manuscript. SJD, JPL, TA, and MK revised the manuscript and contributed to the intellectual content.

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Scott J. Dankel
    • 1
  • Minsoo Kang
    • 2
  • Takashi Abe
    • 1
  • Jeremy P. Loenneke
    • 1
    Email author
  1. 1.Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology LaboratoryThe University of MississippiUniversityUSA
  2. 2.Department of Health, Exercise Science and Recreation Management, Health and Sports Analytics LaboratoryThe University of MississippiUniversityUSA

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