![]() ![]() National Institute for Health and Care Excellence. Accuracy of automated blood pressure measurements in the presence of atrial fibrillation: systematic review and meta-analysis. National Institute for Health and Clinical Excellence: London 2011.Ĭlark CE, McDonagh STJ, McManus RJ. Hypertension: the clinical management of primary hypertension in adults, CG127. ![]() National Institute for Health and Clinical Excellence. European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. O’Brien E, Atkins N, Stergiou G, Karpettas N, Parati G, Asmar R, et al. Automated devices shown to be inaccurate in atrial fibrillationīased on published evidence, a number of devices have been shown to be inaccurate for blood pressure measurement with atrial fibrillation, and cannot be recommended (Table 1). ![]() Such devices are not inherently more accurate in measuring blood pressure with atrial fibrillation, nor can they be assumed to be, in comparison with monitors lacking such technology. Some devices detect pulse irregularity to indicate potentially undiagnosed atrial fibrillation. Devices with atrial fibrillation detection Limited data obtained by static comparison of oscillometric ambulatory blood pressure monitors with mercury readings suggest accuracy for systolic but not diastolic blood pressures measured by the SpaceLabs 90207 and the A&D TM-2430 devices. This may be achieved by taking a sequence of at least three device readings alternating with three auscultatory readings made on the same arm, using a professional analogue device (such as the Accoson Green Light 300). Given the absence of evidence for accuracy of most ambulatory monitors, and the increased individual variation in blood pressure with atrial fibrillation, we recommend comparison of such devices with multiple auscultatory clinic blood pressure readings for all individuals. The Microlife Watch BPA 100 Plus device may be accurate for systolic but not diastolic blood pressure. ![]() įor home use, data from one other study suggest that the Tensoval duo control device is accurate in measuring systolic and diastolic blood pressure. Limited data do exist to suggest that two monitors, designed for professional use, are accurate in measuring systolic, but not diastolic blood pressure: Philips SureSigns VSi and Welch Allyn Vital Signs 300 devices. Home or clinic based automated blood pressure measurementĭue to the absence of evidence for accuracy for most automated monitors designed for home or clinic use, and the increased individual variation in blood pressure with atrial fibrillation, we recommend comparison with multiple auscultatory clinic blood pressure readings for all individuals, when automated devices are used. Using an average of these multiple measurements is advised on the basis of expert opinion. Measurements should be repeated at least three times, regardless of absolute blood pressure, since there is increased intra-person variation in blood pressure with atrial fibrillation. Cuff deflation should be no faster than 2–3 mmHg per second.Īuscultatory methods are recommended due to the lack of evidence for accuracy of most oscillometric devices in the presence of atrial fibrillation. Current and forthcoming BIHS/National Institute for Health and Care Excellence guidance regarding cuff size, seating and avoidance of other causes of error in blood pressure measurement should be followed. Office blood pressure measurements should be carried out using an auscultatory method with a calibrated analogue sphygmomanometer. Office or clinic blood pressure measurement in atrial fibrillation ![]()
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