Cuckson Alexandra C, Moran Paul, Seed Paul, Reinders Annemarie, Shennan Andrew H
Maternal and Foetal Research Unit, GKT School of Medicine, St Thomas' Hospital, London, UK.
Blood Press Monit. 2004 Feb;9(1):31-7. doi: 10.1097/00126097-200402000-00007.
Up to one-third of all blood pressure devices sold are for measurement at the wrist. Wrist monitors are thought to be subject to errors associated with movement and incorrect posture. We used the British Hypertension Society protocol to determine the accuracy of the Omron Rx automated wrist blood pressure monitor in adults. We also investigated the errors associated with miscuffing and posture with measurements at the wrist compared to the upper arm.
The study was conducted at a large teaching hospital in the UK. Participants 18 years and over were eligible for inclusion. Exclusion criteria were cardiac arrhythmias and inaudible Korotkoff sounds. Eighty-five participants were selected for the main validation study. Thirty-four subjects took part in the study investigating miscuffing issues and 15 subjects were included in the study investigating postural errors.
The Omron Rx achieved an overall grade B according to the British Hypertension Society Protocol. The mean differences (standard deviation) between the observers and the device were 0.3 (9.0) and 2.5 (8.8) mmHg for systolic and diastolic blood pressure respectively. In the medium and high-pressure ranges (> or =130/80 mmHg) the device achieved a grade C. When used at home the mean blood pressure reading over 60 measurements in 15 subjects was 123/75 mmHg when taken with the Omron Rx and 124/77 mmHg when taken with the automated upper arm device with no significant difference in the standard deviation of the readings. When compared with mercury sphygmomanometry using both a medium and large cuff, the wrist device readings were closest to the mercury measurements when the most appropriately sized cuff was used.
The Omron Rx wrist monitor is accurate according to the British Hypertension Society protocol, but narrowly fails the Association of the Advancement of Medical Instrumentation criteria. Measurements at the wrist are not associated with miscuffing errors. Use of the wrist device by patients in the home setting gives comparable readings to a standard upper arm device.
售出的所有血压测量设备中，高达三分之一是腕式血压计。人们认为腕式血压计容易出现与运动和姿势不正确相关的误差。我们采用英国高血压学会的方案来确定欧姆龙Rx自动腕式血压计在成人中的准确性。我们还研究了与袖带使用不当和姿势相关的误差，将腕部测量与上臂测量进行了比较。
该研究在英国一家大型教学医院进行。18岁及以上的参与者符合纳入条件。排除标准为心律失常和听不到柯氏音。85名参与者被选入主要验证研究。34名受试者参与了调查袖带使用不当问题的研究，15名受试者被纳入调查姿势误差的研究。
根据英国高血压学会的方案，欧姆龙Rx总体评级为B级。观察者与该设备之间收缩压和舒张压的平均差异（标准差）分别为0.3（9.0）和2.5（8.8）mmHg。在中高压范围（≥130/80 mmHg）内，该设备评级为C级。在家庭环境中使用时，15名受试者进行60多次测量时，使用欧姆龙Rx测得的平均血压读数为123/75 mmHg，使用自动上臂设备测得的平均血压读数为124/77 mmHg，读数的标准差无显著差异。与使用中型和大型袖带的汞柱式血压计相比，当使用尺寸最合适的袖带时，腕式设备的读数最接近汞柱测量值。
根据英国高血压学会的方案，欧姆龙Rx腕式血压计是准确的，但勉强未达到美国医疗仪器促进协会的标准。腕部测量不存在袖带使用不当误差。患者在家中使用腕式设备测得的读数与标准上臂设备相当。
