Department of Nephrology, Charité-Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
Hypertension. 2013 Sep;62(3):579-84. doi: 10.1161/HYPERTENSIONAHA.113.01426. Epub 2013 Jul 29.
The introduction of automated oscillometric blood pressure monitors was the basis for today's widespread use of blood pressure self-measurement. However, in atrial fibrillation, there is a controversial debate on the use of oscillometry because there is a high variability of heart rate and stroke volume. To date, the accuracy of oscillometric blood pressure monitoring in atrial fibrillation has only been investigated using auscultatory sphygmomanometry as reference method, which may be biased by arrhythmia as well. We performed a cross-sectional study in 102 patients (52 sinus rhythm, 50 atrial fibrillation) assessing the accuracy of an automated and validated oscillometric upper arm (M5 Professional, Omron) and wrist device (R5 Professional, Omron) to invasively assessed arterial pressure. Blood pressure values were calculated as the mean of 3 consecutive measurements. Systolic and diastolic blood pressure did not significantly differ in patients with sinus rhythm and atrial fibrillation, independent of the method of measurement (P>0.05 each). The within-subject variability of the oscillometric measurements was higher in patients with atrial fibrillation compared with sinus rhythm (P<0.01 each). The biases of systolic and diastolic blood pressure, however, did not significantly differ in presence or absence of atrial fibrillation in Bland-Altmann analysis (P>0.05 each). In conclusion, atrial fibrillation did not significantly affect the accuracy of oscillometric measurements, if 3 repeated measurements were performed.
自动示波法血压监测仪的引入是当今广泛应用血压自我测量的基础。然而，在心房颤动中，对于示波法的使用存在争议，因为心率和每搏量的变化较大。迄今为止，仅使用听诊法血压计作为参考方法来评估心房颤动中示波法血压监测的准确性，这可能会受到心律失常的影响。我们在 102 名患者（52 名窦性节律，50 名心房颤动）中进行了一项横断面研究，评估了自动验证的上臂（M5 Professional，欧姆龙）和手腕设备（R5 Professional，欧姆龙）的准确性，以评估动脉血压。血压值为 3 次连续测量的平均值。在窦性节律和心房颤动患者中，无论测量方法如何，收缩压和舒张压均无显著差异（P>0.05）。在心房颤动患者中，与窦性节律患者相比，示波法测量的个体内变异性更高（P<0.01）。然而，在 Bland-Altman 分析中，无论是否存在心房颤动，收缩压和舒张压的偏差均无显著差异（P>0.05）。总之，如果进行 3 次重复测量，心房颤动不会显著影响示波法测量的准确性。
