A Meta-analysis to Determine the Validity of Taking Blood Pressure Using the Indirect Cuff Method

Area of Science:

• Cardiovascular physiology
• Medical devices
• Biomedical engineering

Background:

• Blood pressure is commonly measured using the indirect cuff method.
• Concerns exist regarding the accuracy of cuff-based blood pressure measurements compared to direct intra-arterial pressure.
• Numerous studies have investigated discrepancies between these two measurement techniques.

Purpose of the Study:

• To conduct a meta-analysis comparing systematic bias and random error between indirect cuff blood pressure and direct intra-arterial blood pressure measurements.
• To quantify the accuracy of the cuff method in estimating intra-arterial blood pressure.

Main Methods:

• A systematic literature search was performed on PubMed, SportsDiscus, and Scopus databases up to February 2018.
• Data from 62 eligible studies, comprising 103 systolic and 114 diastolic effect sizes, were analyzed using a random effects model.
• Meta-analysis was employed to pool data and assess measurement differences.

Main Results:

• Indirect systolic blood pressure was underestimated by -4.55 mmHg (95% CI: -5.58 to -3.53).
• Indirect diastolic blood pressure was overestimated by 6.20 mmHg (95% CI: 5.09 to 7.31).
• Random error indicated 95% confidence intervals of ±20.2 mmHg for systolic and ±15.5 mmHg for diastolic blood pressure estimations.

Conclusions:

• Accurate estimation of intra-arterial blood pressure using the cuff method may be challenging.
• Findings have implications for clinical hypertension diagnosis and epidemiological studies assessing blood pressure-related health outcomes.
• The potential for underestimation in epidemiological associations between blood pressure and health outcomes is highlighted.