Blood pressure measurement during exercise: a review.

This review summarizes research dealing with the validity of commonly used methods for measuring systemic blood pressure during exercise. Arterial blood pressures measured from within peripheral arteries exaggerate systolic blood pressures because of wave form reflection but provide representative mean and diastolic pressures of the central arterial circulation. Manual and automated sphygmomanometry are the best noninvasive indirect methods of blood pressure measurement to estimate ascending aorta systolic pressures; however, both methods significantly underestimate diastolic pressures at rest and during exercise. The error in diastolic pressure measurement increases with increasing exercise intensity. The accuracy of many indirect noninvasive devices for blood pressure measurement at rest and during exercise can be questioned because of the use of unsuitable criterion methods. Ascending aorta pressures should ideally be used as a gold standard or criterion method for blood pressure measurement during exercise and instrument/method validation. However, given the constraints of varied criterion standards and current recommendations for blood pressure measurement, the following units were found to be acceptable devices for measuring systolic blood pressure during exercise: Accutracker II, A&D TM 2421, Colin 630 (auscultation), Critikon 1165, and possibly the Paramed 9350.