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Published on: May 3, 2018
Influence of Age on Upper Arm Cuff Blood Pressure Measurement
Dean S Picone1, Martin G Schultz1, Petr Otahal1
1From the Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., M.G.S., P.O., J.A.B., N.D., R.F., P.R.-T., J.E.S.).
Insights
Cuff blood pressure (BP) measurement accuracy decreases with age. Older adults may be misdiagnosed due to age-related BP reading discrepancies, impacting cardiovascular risk assessment.
Area of Science:
- Cardiovascular Physiology
- Geriatric Medicine
- Medical Device Technology
Background:
- Blood pressure is a critical global health risk factor.
- Age-related cardiovascular changes may affect cuff BP measurement accuracy.
- Systematic examination of age's influence on cuff vs. invasive BP is lacking.
Purpose of the Study:
- To systematically compare cuff blood pressure (BP) with invasive aortic BP across different age groups.
- To investigate how increasing age influences the accuracy of cuff BP measurements.
- To determine if age-related discrepancies in BP measurement vary across different cuff BP devices.
Main Methods:
- Individual-level data from 31 studies (1674 patients) were analyzed.
- Cuff BP measurements were compared to invasive aortic BP in patients aged 40-89.
- Data included 22 different cuff BP devices (oscillometric, automated auscultation, mercury sphygmomanometry).
Main Results:
- Cuff systolic BP overestimated invasive aortic systolic BP in younger adults (40-49 years).
- With increasing age, cuff systolic BP progressively underestimated invasive aortic systolic BP (P<0.0001).
- Cuff diastolic BP progressively overestimated invasive aortic diastolic BP with age (P<0.0001), leading to increased pulse pressure underestimation.
Conclusions:
- Cuff BP measurement accuracy is significantly influenced by patient age.
- Older individuals may face a higher risk of misdiagnosis due to age-related BP measurement errors.
- These findings highlight potential challenges in accurately assessing cardiovascular risk in aging populations.
Abstract:
Blood pressure (BP) is a leading global risk factor. Increasing age is related to changes in cardiovascular physiology that could influence cuff BP measurement, but this has never been examined systematically and was the aim of this study. Cuff BP was compared with invasive aortic BP across decades of age (from 40 to 89 years) using individual-level data from 31 studies (1674 patients undergoing coronary angiography) and 22 different cuff BP devices (19 oscillometric, 1 automated auscultation, 2 mercury sphygmomanometry) from the Invasive Blood Pressure Consortium. Subjects were aged 64±11 years, and 32% female. Cuff systolic BP overestimated invasive aortic systolic BP in those aged 40 to 49 years, but with each older decade of age, there was a progressive shift toward increasing underestimation of aortic systolic BP (P<0.0001). Conversely, cuff diastolic BP overestimated invasive aortic diastolic BP, and this progressively increased with increasing age (P<0.0001). Thus, there was a progressive increase in cuff pulse pressure underestimation of invasive aortic PP with increasing decades of age (P<0.0001). These age-related trends were observed across all categories of BP control. We conclude that cuff BP as an estimate of aortic BP was substantially influenced by increasing age, thus potentially exposing older people to greater chance for misdiagnosis of the true risk related to BP.
Related Concept Videos
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:23Assessment of blood pressure in brachial artery(two-step method)
01:17Measurement of Blood Pressure
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure: