Blood pressure measurement in the elderly with atrial fibrillation: an observational study comparing different noninvasive sphygmomanometers

Shaojun Mai; Hailan Zhu; Meijun Li; Yanfang Zeng; Yang Zhang; Yanchang Huo; Xiong-Fei Pan; Yuli Huang

doi:10.1177/20406223221137040

Blood pressure measurement in the elderly with atrial fibrillation: an observational study comparing different noninvasive sphygmomanometers

Ther Adv Chronic Dis. 2022 Nov 14:13:20406223221137040. doi: 10.1177/20406223221137040. eCollection 2022.

Authors

Shaojun Mai¹, Hailan Zhu¹, Meijun Li¹, Yanfang Zeng¹, Yang Zhang¹, Yanchang Huo², Xiong-Fei Pan³, Yuli Huang^{2

4}

Affiliations

¹ Department of Cardiology, Shunde Hospital, Southern Medical University, Guangdong, China.
² Department of Cardiology, Shunde Hospital, Southern Medical University, Jiazi Road 1, Lunjiao Town, Shunde District, Foshan, Guangdong 523808, China.
³ Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
⁴ The George Institute for Global Health, Newtown, NSW, Australia.

Abstract

Background: Atrial fibrillation (AF) has affected millions of adults in the world. It is important to monitor and manage blood pressure (BP) in AF patients. The accuracy of BP monitoring in AF patients with noninvasive methods remains questionable, however.

Objectives: To compare the accuracy of different noninvasive BP devices (oscillographic sphygmomanometer and pulse wave device) for BP measurement in elderly patients with AF, with a mercury sphygmomanometer as a reference.

Design: This study was an observational study.

Methods: Patients with AF from the inpatient department of cardiology were included from 1 January to 31 December 2020. BP measurements were performed by two trained nurses using a tee junction connection on the cuff to connect three sphygmomanometers. The Bland-Altman plot analysis was conducted to compare the agreement of BP measurements. We also compared the agreement of BP measurements through metrics such as accuracy, bias, and precision.

Results: A total of 202 patients (54.5% female) were included. The Bland-Altman plot analysis showed that the lower and upper limits of agreement (LoAs) of pulse wave/reference were similar to the predefined acceptable clinical limits (10/5 mmHg). The bias and precision in both systolic and diastolic BP were significantly less in pulse wave/reference (a bias of 1.8 and 0.77 mmHg and a precision of 5.20 and 4.66 mmHg, respectively), with corresponding higher accuracy readings (98.51% for P10 in systolic BP and 85.64% for P5 in diastolic BP).

Conclusion: A novel noninvasive sphygmomanometer - pulse wave device has a good concordance with a mercury sphygmomanometer in BP monitoring, and may be applicable to perform BP measurements in the elderly with AF.

Keywords: atrial fibrillation; blood pressure measurement; noninvasive sphygmomanometer; oscillographic sphygmomanometer; pulse wave sphygmomanometer.