The accuracies of pulse wave and oscillometric electronic sphygmomanometers for blood pressure measurements in obese people

XU Hai*, HOU Lei, ZUO Hui-juan, WANG Qin-fu, QIN Fang,

CHEN Xiao-rong, ZHANG Ji-yu, WANG Zeng-wu, MA Ji-xiang

*Department of Cardiovascular and Ce『ebrovascular, National Center for Chronic and Noncommunicable

Disease Control and prevention.Chinese Center for Disease Control and Prevention, Beijing 100050, China

Abstract: Objective To evaluate the accuracies of pulse wave and oscillometric electronic sphygmomanometers for blood pressure measurements in obese people.

Methods Community-based men and women, aged􀂚18 years whose body mass index(BMI) were 30 kg/m² more were recruited in Laiwu city, Shangdong province in September 2015. A four-way pipe was used to link the desktop mercury sphygmomanometer, electronic sphygmomanometer to subjects simultaneously. The blood p『essure value recorded by the desktop mercury sphygmomanometer was considered as a golden standard. Intra class correlation coefficient (ICC), Bland-Altman method, and allowable total error(ATE/limits for erroneous results zones(LER)zones were used for evaluating the accuracy of two electronic sphygmomanometers compared to mercuries sphygmomanometer.
Results A total of 118 subjects were enrolled. The ICC of pulse wave electronic sphygmomanometer-desktop mercury sphygmomanometer were 0.99(95% Cl 0.99~1.00)for systolic blood pressures and 0.96 (95% Cl 0.90~0.98) for diastolic blood pressures. The ICC of oscillometric electronic sphygmomanometer-desktop mercury sphygmomanometer were 0.98 (95% Cl 0.97~0.99) fo『 systolic blood pressures and 0.90 (95% Cl 0.44~0.96) for diastolic blood pressures. Bland-Altman test showed that the mean systolic blood pressure difference closed to zero reference line, while the mean diastolic blood pressure difference was below the zero-『eference line.especially in oscillometric sphygmomanometer (-5.7 vs -2.6 mmHg, P<0.05).ATE/LER zones analysis showed that more than 95% values for systolic blood pressu『es in two sphygmomanometers fell within the ATE zones. For diastolic blood pressure values in pulse wave electronic sphygmomanometer,4.2%, and 0% measured values fell within the inte『mediate zones and LER zones respectively the corresponding proportions in oscillometric electronic sphygmomanometer were 19.5% and 0.8%.

 

Conclusion: This study indicated that both pulse wave and oscillometric electronic sphygmomanometer have good accuracies in systolic blood pressure measurement.however.underestimated diastolic blood pressure.particularly in oscillometric electronic sphygmomanometer in obese people.
Keywords: sphygmomanometers; blood pressure measurement; accuracy

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3-Obese people & Blood Pressure Measurement

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Structure of coronavirus

Those with high blood pressure are at a greater risk for Covid-19. Here’s what you need to know to protect yourself

(CNN)As the novel coronavirus sweeps the globe, people with high blood pressure are among those who are at heightened risk for more severe complications should they contract Covid-19.

“If you get an extraordinary viral disease that will damage your lungs, you need a heart that can work with how your body responds to the virus,” said Dr. Maria Carolina Delgado-Lelievre, an assistant professor of medicine at the University of Miami’s Miller School of Medicine.
But for those with hypertension, “Covid will cause a systemic reaction in the body in a patient that already has risk” because of poor heart health, she said. That means the virus can attack multiple organ systems.
The CDC’s Morbidity and Mortality Weekly Report from February 12 to March 28 showed that 9% of Covid-19 patients in the United States also self-reported a diagnosis of cardiovascular disease.
High blood pressure is the most common type of heart disease and affects almost half of all American adults, according to the CDC. That’s about 108 million Americans living with the condition.
And because hypertension is more common as people grow older, that means many of the same people with high blood pressure already overlap with the elderly populations known to be at higher risk for contracting Covid-19.

Structure of coronavirus

Recognize the warning signs and know how to take your blood pressure

At a basic anatomic level, hypertension happens when there’s an abnormality in blood vessels that can impair the way oxygen is transferred to the cells.
Having a low blood oxygen level is common among those hospitalized with Covid-19, according to a study of patients in Wuhan, China published in the Lancet in January.
“High blood pressure is not [just] a number. The number is a guide, it’s a symbol,” Delgado-Lelievre said. “It’s telling us your vessels all over the body are not working as they should.”
High blood pressure may not come with noticeable symptoms, so the best way to identify it is to simply do a blood pressure reading.

The American Heart Association published a graphic explaining basic facts about monitoring your blood pressure. During this pandemic, it’s an important number to keep an eye on.

To do that, first, make sure you have a blood pressure cuff. Today’s technology is accurate enough that using a digital wrist cuff can get a good blood pressure reading, Delgado-Lelievre said.
Next, rest in a sturdy chair for at least five minutes, making sure to sit with your back straight. Keep your forearms supported on a flat surface such as a table, and keep the blood pressure cuff placed directly above where your elbow bends.
As you’re monitoring blood pressure over time, make sure to take the readings at the same time every day.
Any blood pressure reading of 120 over 80 is considered elevated, Delgado-Lelievre said.
Moving up from that point, the first level of hypertension is defined as 130 or higher for systolic (the top number) and 80 or higher for diastolic (the lower number), according to the American Heart Association.

Maintain a healthy lifestyle and keep taking your medicine

During the pandemic, the best way those with hypertension can manage their own risk is to follow the same guidelines as everyone else: maintain social distancing, wash hands frequently and refrain from touching one’s face.
More specific to high blood pressure, it’s important to try to relax as much as possible, as stress commonly drives up readings.
With so much of society upended by social distancing and the threat of more infections, relaxing is obviously easier said than done. But do as well as you can to try to keep your blood pressure at a healthy level.

Although hypertension is a genetic disease, it has external drivers such as lifestyle, diet and exercise.
Delgado-Lelievre said she often tells patients that if they come up with an unusually high blood pressure reading they should try relaxation exercises, or lie down and listen to music. Then they should take their blood pressure again, and they will likely see a drop.
“Some people already know they have hypertension and know they need to monitor their blood pressure two or three times a week,” she added.
And despite some recent rumors to the contrary, doctors still recommend taking medications your doctor may have prescribed for blood pressure, including ACE inhibitors and ARBs, the American Heart Association says.
“Do not stop your medications unless your doctor tells you to,” Delgado-Lelievre said.

The African American community is at higher risk

Doctors fighting against the coronavirusIt’s not just adults over 60; African Americans are also at a higher risk for hypertension, according to a study published in the Journal of the American Heart Association.
US Surgeon General Jerome Adams told “CBS Sunday Morning” that he has high blood pressure, noting “I have heart disease, and I and many black Americans are at higher risk for Covid,” he said.

CNN political commentator Van Jones echoed Adams.
“All the doctors are saying: people who have high blood pressure and hypertension are very at risk to dying when they get this virus,” Jones said. “Nobody is saying that to the black community loudly enough.”
For groups more likely to have co-morbid conditions or other risk factors, including African Americans and the elderly, Jones had blunt advice.
“What that means is if your grandmother has high blood pressure or diabetes, grab her and pull her into the house and do not let her out for two months,” he said.
“Those with hypertension have to be very cautious about maintaining the quarantine,” Delgado-Lelievre added.