Related Experiment Videos
Measuring blood pressure in the elderly: does atrial fibrillation increase observer variability?
D Sykes1, R Dewar, K Mohanaruban
1University Department of Geriatric Medicine, Cardiff Royal Infirmary.
BMJ (Clinical Research Ed.)
|January 20, 1990
Summary
Blood pressure measurement variability is higher in elderly patients with atrial fibrillation compared to sinus rhythm. This difference in interobserver and intraobserver variability may impact clinical decisions.
Area of Science:
- Geriatric Medicine
- Cardiology
- Clinical Measurement
Background:
- Blood pressure (BP) measurement is a cornerstone of cardiovascular assessment.
- Variability in BP measurement can arise from interobserver (between different clinicians) and intraobserver (same clinician at different times) factors.
- Atrial fibrillation (AF) is a common arrhythmia in the elderly, potentially affecting BP measurement accuracy.
Purpose of the Study:
- To compare the interobserver and intraobserver variability of BP measurements in geriatric patients with atrial fibrillation versus those in sinus rhythm.
Main Methods:
- Prospective study involving 50 elderly patients with AF and 50 with sinus rhythm.
- Five physicians performed BP measurements in random order.
- Variability assessed using the coefficient of variability and compared with the Mann-Whitney U test.
Main Results:
- Significantly greater interobserver variability for both systolic and diastolic BP in the AF group.
- Significantly greater intraobserver variability for diastolic BP in the AF group.
- No significant difference in intraobserver variability for systolic BP between groups.
Conclusions:
- Physicians' interpretation of Korotkoff sounds is less uniform in patients with AF.
- This increased variability in BP measurement in AF patients may have clinical implications.
- Standardized BP measurement protocols may mitigate this variability.