Comparison between Manual Device and Automated Blood Pressure Cuff

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TOC o “1-3” h z u Comparison between Manual Device and Automated Blood Pressure Cuff PAGEREF _Toc317675784 h 3Introduction PAGEREF _Toc317675785 h 3Review of the Articles PAGEREF _Toc317675786 h 3Discussion PAGEREF _Toc317675787 h 4Conclusion PAGEREF _Toc317675788 h 5References PAGEREF _Toc317675789 h 6

Comparison between Manual Device and Automated Blood Pressure CuffIntroductionThis paper posits to provide a comparison between manual device and automated blood pressure cuff. It will base the comparison on two topical journal articles in this regard. Debates concerning patient populations, clinical trials, as well as statistical analyses may appear to be distant and hollow when observing an anxious patient inside an examination room. At such a moment, what matters are the patient’s best interests. Yet clinically pertinent data, and more significantly, careful discussion of that information provides the solution. Professional clinicians often require the former so as to successfully deliver the latter (Landgraf et al., 2010). In this regard, two comparable journal articles were in recent times published arriving at arrived two different conclusions. The first journal is “Comparison of Automated Oscillometric Versus Auscultatory Blood Pressure Measurement”, authored Johanna Landgraf, Stanley Wishner, and Robert Kloner. The American Journal of Cardiology published this journal. The other article is “Why Automated Office Blood Pressure Should Now Replace the Mercury Sphygmomanometer”, authored by Martin G. Myers. This article is available in the Journal of Clinical Hypertension. 

Review of the ArticlesIn the first journal, the authors introduce concerns regarding the utilization of automated oscillometric BP devices. The article reports significant dissimilarity observed in blood pressure readings taken concurrently by use of the auscultatory/mercury procedure as well as the automated oscillometric procedure. The authors report that manual auscultatory outcomes were characteristically higher than the ones utilizing automated oscillometric devices, predominantly in aged patients. The mean inconsistency between techniques was reported as approximately 2 mm Hg. The major concern in the article is the likelihood for a number of hypertensive patients to undergo under treatment as a result (Landgraf et al., 2010).

In the second article, Myers asserts that, the mercury sphygmomanometer has become a hindrance to the provision of optimum care towards the patient with hypertension in regular clinical practice. The author’s argument is based on the multitude of extraneous factors connected with manual blood pressure measurement in the real-life world, which lead to blood pressure readings of erratic accuracy and quality. Myers alleges that automated oscillometric devices that have been autonomously validated for precision would help eliminate such variability (Myers, 2010).

DiscussionTechnical observations concerning the first article assert that the discrepancies between automated and manual techniques are significant. It may be inaccurate to allege that an observer mean SYS of 133 +/- 20 mmHg is considerably larger than the device mean SYS of 131 +/- 18 mmHg. On the contrary, these values are reasonably comparable in the majority of clinical settings. This is the case especially when considering that the majority of auscultatory BPs performed by medical staff depicts faster deflation rates than alleged by the study. Additionally, since the study utilized the same cardiologist for each of the manual readings, it would be probable that an observer-to-observer assessment would depict similar differences.

The majority of clinical offices depend on automated oscillometric devices in measuring blood pressure, but the precision of this technique as opposed to, auscultatory determination utilizing a mercury manometer is contentious. According to Landgraf et al. (2010) to determine the precision of readings from automated oscillometric, blood pressure was computed from the same cuff and site, in 337 successive patients seen in a regular cardiology office, utilizing a simultaneous link to an automated oscillometric as well as, a mercury manometer procedure. The mean systolic BP (133 ± 20 mm Hg) as well as diastolic BP (72 ± 11 mm Hg) were considerably greater in using the mercury manometer than with the automated oscillometric procedure (systolic 131 ± 18 and diastolic 70 ± 12 mm Hg, p <0.0001). Divergence, roughly at all times lower oscillometric as well as greater mercury manometer in systolic blood pressure were observed in 22% of all patients. Divergence in diastolic blood pressure was observed in 20% of all patients. The mean of the divergence between the two procedures was 1.95 ± 5 mm Hg (range 1 to 26) for systolic blood pressure and 1.3 ± 4 mm Hg (range 1 to 25) for diastolic blood pressure. The divergence was larger in patients above 65 years of age.

ConclusionThe mercury manometer procedure led to consistently larger blood pressure values than in oscillometric devices. These outcomes bear imperative clinical implications, together with the theory that patients whose blood pressure seems to be under control in utilizing the oscillometric technique may not be in their goal BP and may have under gone under treatment.

ReferencesLandgraf, J., Stanley, W., & Robert, K. (2010). Comparison of Automated Oscillometric versus Auscultatory Blood Pressure Measurement. American Journal of Cardiology, 106, (3). 386-388.

Myers, M. (2010). Why Automated Office Blood Pressure Should Now Replace the Mercury Sphygmomanometer. The Journal of Clinical Hypertension, 12, (7), 1.