Automated 'oscillometric' blood pressure measuring devices: how they work and what they measure

Dyslipidemia and cerebral atrophy among health check-up individuals: A cross-sectional study

Objective

To examine the association between dyslipidemia and cerebral atrophy in Chinese health check-up population.

Methods

67,526 participants underwent routine health check-ups at the health management center of the First Affiliated Hospital of Sun Yat-Sen University (FAH-SYSU) in Guangzhou for two years (2022-2023) in this cross-sectional study. Cerebral atrophy was determined by expert physicians based on non-contrast scans of Head Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiography (MRA) and/or Head Computed Tomography (CT). The levels of Total Cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured and classified by quartiles into four categories, respectively. The multivariable logistic regression model was used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs).

Results

A total of 1,661 participants were included with ages from 18 to 93 years. Among 1,661 participants, 121 (7.28%) had cerebral atrophy. On multivariate analysis, TC and LDL-C were not associated with cerebral atrophy, although TC and LDL-C were lower in the subgroup with cerebral atrophy.

Conclusions

This cross-sectional study conducted in China is the first to identify that health check-up examinees with cerebral atrophy had lower levels of TC and LDL-C raising the possible association between lower levels of TC and LDL-C with cerebral atrophy, and possible cognitive dysfunction. Future study is planned to overcome the existing limitation and address the lack of statistically significant association between TC and LDL-C levels with cerebral atrophy and possible dementia.

Community Health Workers Equipped with an mHealth Application Can Accurately Diagnose Hypertension in Rural Guatemala

Background

Hypertension is a leading global cause of morbidity and mortality and is increasing in low- and middle-income countries, where unawareness of hypertension is a primary obstacle to management. Community health workers (CHWs) in combination with mobile health (mHealth) tools are increasingly used in LMIC health systems to strengthen primary care infrastructure. In this study, we applied this care model to hypertension in rural Guatemala by comparing the accuracy of CHWs equipped with an mHealth clinical decision support application in diagnosing hypertension to concurrent physician evaluation.

Methods

We performed a prospective diagnostic accuracy study in which adults from rural Guatemalan communities were assessed independently by a CHW aided by a mHealth application and a physician. Assessment included medical history; measurement of blood pressure, height and weight; and determination of hypertension status. CHW-physician agreement on hypertension status and past medical history elements was assessed by Kappa analysis and proportional agreement, with a priori thresholds of Kappa = 0.61 and agreement of 90%. Agreement on patient measurements was evaluated using Bland-Altman and regression analyses.

Results

Of 359 participants enrolled, 47 (13%) were confirmed to have hypertension and another 11 (3%) had possible hypertension. CHW-physician agreement was high for hypertension diagnosis, with Kappa = 0.8 (95% CI = 0.72, 0.88) and overall agreement 92.8% (95% CI = 90.1%, 95.4%). Bland-Altman analysis showed small biases toward lower systolic blood pressure, higher height, and lower BMI measurements by CHWs. Most patient history characteristics showed moderate to almost perfect (Kappa: 0.41-1) agreement between physicians and CHWs.

Conclusions

In this study based in rural Guatemala, CHWs using a mHealth clinical decision support application were found to screen adult patients for hypertension with similar accuracy to a physician. This approach could be adapted to other low-resource settings to reduce the burden of undiagnosed and untreated hypertension.

Hypertension Canada Statement on the Use of Cuffless Blood Pressure Monitoring Devices in Clinical Practice

BACKGROUND

Cuffless blood pressure (BP) devices are an emerging technology marketed as providing frequent, nonintrusive and reliable BP measurements. With the increasing interest in these devices, it is important for Hypertension Canada to provide a statement regarding the current place of cuffless BP measurements in hypertension management.

METHODS

An overview of the technology in cuffless BP devices, the potential with this technology and the challenges related to determining the accuracy of these devices.

RESULTS

Cuffless BP monitoring is an emerging field where various technologies are applied to measure BP without the use of a brachial cuff. None of the devices currently sold have been validated in static and dynamic conditions using a recognized validation standard. Important issues persist in regard to the accuracy and the place of these devices in clinical practice. Current data only support using validated cuff-based devices for the diagnosis and management of hypertension. Presently, readings from cuffless devices that are used for diagnosis or clinical management need to be confirmed using measurements obtained from a clinically validated BP device.

CONCLUSIONS

Cuffless BP devices are a developing technology designed to track BP in most daily life activities. However, many steps remain before they should be used in clinical practice.

Blood Pressure Difference Between Cuff Inflation and Deflation by Auscultatory Method: Impact of Hypertension Grade

Background: The aim of this study was to evaluate blood pressure (BP) difference between cuff inflation and deflation and to investigate whether hypertension grade and patients' characteristics could be influential. Methods: We selected 328 asymptomatic patients, 219 with mild systolic/diastolic hypertension, 75 with moderate systolic/diastolic hypertension and 34 with severe systolic/diastolic hypertension. Results: Hypertension grade was a determinant of the difference between systolic/diastolic BP during cuff inflation and deflation; the difference was progressively and significantly higher from mild to moderate to severe hypertension (1.80 ± 1.03/1.21 ± 0.56 vs. 5.32 ± 1.09/3.04 ± 0.81 vs. 9.74 ± 1.46/4.88 ± 0.73 mmHg, respectively (all differences were significant). Age, gender, body mass index, smoking habits and laboratory parameters were not associated with BP differences. The observed differences led to a reclassification of 24% of patients with moderate and 32% of patients with severe hypertension to a lower grade, but all were classified as hypertensive patients during cuff inflation. Conclusions: Hypertension grade influences the difference in systolic/diastolic BP during cuff inflation and deflation. This difference leads to a reclassification of hypertension grade during cuff inflation within the hypertensive range but does not influence the definition of hypertensive status. Future studies are needed to confirm whether the differences in systolic/diastolic BP between cuff inflation and deflation are due to BP increases induced by sympathetic activation, as well as a potential different behavior of the brachial artery during closing or opening, or both.

Mean arterial pressure differences between cuff oscillometric and invasive blood pressure

Differences between automated cuff oscillometric blood pressure (BP) and invasive measurements are well described, but the causes are not fully understood. Automated BP devices record cuff oscillometric mean arterial pressure (MAP) as a key measurement step that is presumed to be accurate, but if not, could create error in cuff systolic (SBP) and diastolic BP (DBP) estimations. This has never been determined and was the aim of the study. Data from five studies with similar protocols were analysed (N = 262 patients undergoing coronary angiography, 61 ± 11 years, 65% male). Cuff oscillometric MAP was measured using five different models of automated cuff BP devices simultaneous to invasively measured MAP (fluid-filled or solid-state catheters). Cuff SBP and DBP were estimated by device-specific algorithms. Differences (∆) were calculated as cuff-invasive aortic BP. There were significant associations between ∆MAP and ∆SBP in four out of five devices (unstandardised β range = 0.42-1.04). The ∆MAP explained 6-52% of the variance in ∆SBP. In the same four devices, there were significant associations between ∆MAP and ∆DBP (unstandardised β range = 0.57-0.97) and ∆MAP explained 35-52% of the variance in ∆DBP. In conclusion, there are differences between cuff oscillometric MAP and invasive MAP which are associated with ∆SBP and ∆DBP. Further research is required to improve cuff oscillometric BP and greater transparency needed to understand algorithms used in these devices.

First true blood pressure measurement with micropulse detection of arterial opening achieved

There is a well-accepted need for a new more accurate solution to automatic blood pressure measurement, in spite of clinical convenience continuing to encourage the adoption of oscillometric devices with their known poor accuracy throughout healthcare. Our solution avoids estimates, mathematical modelling, oscillometric algorithms, and inadequate calibration against numerous private clinical data sets. Here we show that our new technique detects, from an arm cuff, micropulses associated with arterial opening between systolic and diastolic pressures; hence detecting systole at the first micropulse and diastole at the last, during cuff deflation. Our technique has equivalent accuracy to the gold standard auscultatory method, and is significantly better than the requirements of the current international standard for blood pressure devices. Our results provide scientific evidence for the effectiveness of our technique, and demonstrate significant clinically important improvements. We anticipate that our technique can be automated easily and economically. We acknowledge that this early study is an initial manual evaluation, but expect this new technique to be an automated universal solution for true blood pressure measurement, and a vital step change in an important clinical measurement in healthcare of the worldwide population.

Validation of the Hanvon FY730 upper-arm blood pressure monitor according to the AAMI/ESH/ISO universal standard (ISO 81060-2:2018)

This study evaluates the measurement accuracy of the Hanvon FY730 upper-arm blood pressure (BP) monitor, which uses the Korotkoff sound method, in compliance with the AAMI/ESH/ISO universal standard (ISO 81060-2:2018). A clinical trial involving 86 eligible adults was conducted, and data were analyzed based on standardized protocols. The mean differences between the device and reference measurements for systolic blood pressure (SBP) and diastolic blood pressure (DBP) were -0.37 mmHg (SD: 2.25 mmHg) and -0.17 mmHg (SD: 2.02 mmHg), respectively. Standard deviations for SBP (≤6.93 mmHg) and DBP (≤6.95 mmHg) met the required thresholds. A total of 258 effective paired measurements demonstrated that the Hanvon FY730 provides highly consistent results compared with reference methods, with all deviations falling within acceptable limits. The study also confirmed the device's reliability across a wide range of arm circumferences (22-36 cm) and BP levels (SBP: 90-188 mmHg, DBP: 53-107 mmHg). These findings confirm that the Hanvon FY730 complies with ISO 81060-2:2018 standards, demonstrating its suitability for accurate BP monitoring in clinical, personal, and home settings.

Are previously validated blood pressure self-measurement devices accepted under the Universal Standard? A systematic review

This study aimed to analyze whether oscillometric blood pressure devices validated for the general population may be considered approved under Universal Standard criteria. A systematic review was conducted, with searches in nine databases, up to September 2023, including 32 validation studies of noninvasive arm cuff devices for self-measurement. The British Hypertension Society protocol was most common (68%), followed by the Association for the Advancement of Medical Instrumentation (40%). Most devices met Universal Standard criterion 1, but only 17 (53%) met criterion 2. Few studies contained details about the choice of cuffs, the number of participants by arm circumference, or the differences between methods by cuff subgroup. Due to the considerable differences between validation protocols, 53% of the devices analyzed were approved under the Universal Standard. The study contributes to expanding the validated pool of self-measurement devices under the Universal Standard.

Validation of two automatic sphygmomanometers according to the modified International Standardization Organization 81060-2:2018 protocol in adults with a mid-upper arm circumference of 22 centimeters or less

OBJECTIVE

A recent International Organization for Standardization (ISO) Task Group report calls for research to investingate potential special populations in validation studies of automated blood pressure (BP) devices. Accordingly, we aimed to determine the accuracy of two previously validated BP monitors passed in a general population when measured in adults with a mid-upper arm circumference (MUAC) ≤ 22 cm.

METHODS

Test device A was the OMRON HEM 7121 equipped with the HEM CS24 cuff designed for an arm circumference of 17-22 cm. Test device B was the YuWell YE660Е with the YuWell '360°' cuff (18-36 cm). Data from 37 participants aged 20.14 ± 2.23 (18-28) years were analyzed according to criterion 1 of ISO Standard 81060-2 : 2018.

RESULTS

According to criterion 1, the mean ± SD of the BP differences for the device A was -7.81 ± 5.20/-10.66 ± 5.48 mmHg (systolic/diastolic) and for the device B was -8.00 ± 6.30/-16.11 ± 5.15 mmHg (systolic/diastolic), respectively. This means that neither device met the requirements.

CONCLUSION

Since devices A and B, which had passed in a general population study, failed in adults aged 18-28 years with an MUAC ≤ 22 cm, such individuals might be considered as new special population for validation studies.

Central blood pressure and peripheral augmentation index following acute submaximal arm versus leg exercise

BACKGROUND

Aerobic exercises like running and cycling may lower cardiovascular disease (CVD) risk through favorable effects on central blood pressure and vascular function. Arm ergometry is a popular exercise modality used in rehabilitation settings, but little is known regarding the central hemodynamic and vascular effects of this form of exercise.

PURPOSE

To compare the acute effects of leg versus arm exercise on central blood pressure and vascular function.

METHODS

Twenty-one participants (n = 11 female, Age 21 ± 3, BMI 24.5 ± 3.2 kg/m2) completed two visits to the Human Performance Laboratory. Central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), and peripheral augmentation index (pAIx) were measured using a brachial oscillometric blood pressure cuff with measures being taken before and after 20 min of acute moderate-intensity (submaximal) arm or leg cycling exercise.

RESULTS

There was a condition-by-time interaction for pAIx (p = 0.011). pAIx slightly increased following arm exercise but significantly decreased following leg exercise. There was a condition-by-time interaction for cDBP (p = 0.011). cDBP significantly decreased following arm exercise but increased immediately following leg exercise. There was no condition-by-time interaction for cSBP (p = 0.721). There were similar acute increases in cSBP immediately post-exercise for both conditions.

CONCLUSION

Arm exercise increased pAlx and decreased cDBP compared to leg exercise. As an increase in pAIx may increase left ventricular work and a reduction in cDBP may reduce coronary perfusion pressure, these findings suggest that a single bout of arm exercise may not have the same favorable acute effect on central hemodynamic load as a single bout of leg exercise.

Cuff-based blood pressure measurement: challenges and solutions

OBJECTIVE

Accurate measurement of arterial blood pressure (BP) is crucial for the diagnosis, monitoring, and treatment of hypertension. This narrative review highlights the challenges associated with conventional (cuff-based) BP measurement and potential solutions. This work covers each method of cuff-based BP measurement, as well as cuffless alternatives, but is primarily focused on ambulatory BP monitoring.

RESULTS

Manual BP measurement requires stringent training and standardized protocols which are often difficult to ensure in stressful and time-restricted clinical office blood pressure monitoring (OBPM) scenarios. Home Blood pressure monitoring (HBPM) can identify white-coat and masked hypertension but strongly depends on patient adherence to measurement techniques and procedure. The widespread use of nonvalidated automated HBPM devices raises further concerns about measurement accuracy. Ambulatory blood pressure measurement (ABPM) may be used in addition to OBPM. It is recommended to diagnose white-coat and masked hypertension as well as nocturnal BP and dipping, which are the BP values most predictive for major adverse cardiac events. Nonetheless, ABPM is limited by its non-continuous nature and susceptibility to measurement artefacts. This leads to poor overall reproducibility of ABPM results, especially regarding clinical parameters such as BP variability or dipping patterns.

CONCLUSIONS

Cuff-based BP measurement, despite some limitations, is vital for cardiovascular health assessment in clinical practice. Given the wide range of methodological limitations, the paradigm's potential for improvement is not yet fully realized. There are impactful and easily incorporated opportunities for innovation regarding the enhancement of measurement accuracy and reliability as well as the clinical interpretation of the retrieved data. There is a clear need for continued research and technological advancement to improve BP measurement as the premier tool for cardiovascular disease detection and management.

Accuracy of methods to estimate central aortic SBP via upper arm cuff: a systematic review and meta-analysis

OBJECTIVES

Central aortic BP may predict cardiovascular outcomes better than upper arm brachial BP. In recent years, technology has enabled central BP estimation by recording a peripheral BP waveform from a standard upper arm cuff. The accuracy of these devices is not well documented, and this study aimed to address this issue.

METHODS

This study was a systematic review, conducted according to PRISMA guidelines, of observational studies published between 2008 and 2023 that reported accuracy testing of cuff-based central BP devices, compared with reference invasive aortic BP. The primary analysis was stratified according to each commercially available device. Pooled estimates were calculated using random-effects models based on mean differences and standard errors.

RESULTS

Six thousand four hundred and fifteen studies were screened, and 27 studies met inclusion criteria (plus one unpublished study). This generated data for seven devices that are commercially available, which were tested among 2125 adult participants. There was very high heterogeneity when all devices were pooled ( I2  = 97.5%), and, when stratified by device, the accuracy of estimated central BP was highly device-dependent (range of accuracy across different devices -12.4 mmHg (-16.3 to -8.5) to 3.2 mmHg (0.2-6.1). Two of the seven commercially available devices had not undergone external validation testing.

CONCLUSION

The accuracy of commercially available cuff-based central BP devices is highly device-specific and not all are accurate for the estimation of central SBP. These findings have major implications for the appropriate interpretation of studies that use cuff-based estimated central BP.

Resonance sonomanometry for noninvasive, continuous monitoring of blood pressure

Cardiovascular disease is the leading cause of death worldwide. Existing methods for continuous, noninvasive blood pressure (BP) monitoring suffer from poor accuracy, uncomfortable form factors, or a need for frequent calibration, limiting their adoption. We introduce a new framework for continuous BP measurement that is noninvasive and calibration-free called resonance sonomanometry. The method uses ultrasound imaging to measure both the arterial dimensions and artery wall resonances that are induced by acoustic stimulation, which offers a direct measure of BP by a fully determined physical model. The approach and model are validated in vitro using arterial mock-ups and then in multiple arteries in human subjects. This approach offers the promise of robust continuous BP measurements, providing significant benefits for early diagnosis and treatment of cardiovascular disease.

Validation of a Suprasystolic Cuff System for Static and Dynamic Representation of the Central Pressure Waveform

BACKGROUND

Noninvasive pulse waveform analysis is valuable for central cardiovascular assessment, yet controversies persist over its validity in peripheral measurements. Our objective was to compare waveform features from a cuff system with suprasystolic blood pressure hold with an invasive aortic measurement.

METHODS AND RESULTS

This study analyzed data from 88 subjects undergoing concurrent aortic catheterization and brachial pulse waveform acquisition using a suprasystolic blood pressure cuff system. Oscillometric blood pressure (BP) was compared with invasive aortic systolic BP and diastolic BP. Association between cuff and catheter waveform features was performed on a set of 15 parameters inclusive of magnitudes, time intervals, pressure-time integrals, and slopes of the pulsations. The evaluation covered both static (subject-averaged values) and dynamic (breathing-induced fluctuations) behaviors. Peripheral BP values from the cuff device were higher than catheter values (systolic BP-residual, 6.5 mm Hg; diastolic BP-residual, 12.4 mm Hg). Physiological correction for pressure amplification in the arterial system improved systolic BP prediction (r2=0.83). Dynamic calibration generated noninvasive BP fluctuations that reflect those invasively measured (systolic BP Pearson R=0.73, P<0.001; diastolic BP Pearson R=0.53, P<0.001). Static and dynamic analyses revealed a set of parameters with strong associations between catheter and cuff (Pearson R>0.5, P<0.001), encompassing magnitudes, timings, and pressure-time integrals but not slope-based parameters.

CONCLUSIONS

This study demonstrated that the device and methods for peripheral waveform measurements presented here can be used for noninvasive estimation of central BP and a subset of aortic waveform features. These results serve as a benchmark for central cardiovascular assessment using suprasystolic BP cuff-based devices and contribute to preserving system dynamics in noninvasive measurements.

Smartphone-Based versus Non-Invasive Automatic Oscillometric Brachial Cuff Blood Pressure Measurements: A Prospective Method Comparison Volunteer Study

Introduction: Mobile health diagnostics have demonstrated effectiveness in detecting and managing chronic diseases. This method comparison study aims to assess the accuracy and precision of the previously evaluated OptiBP™ technology over a four-week study period. This device uses optical signals recorded by placing a patient's fingertip on a smartphone's camera to estimate blood pressure (BP). Methods: In adult participants without cardiac arrhythmias and minimal interarm blood pressure difference (systolic arterial pressure (SAP) < 15 mmHg or diastolic arterial pressure (DAP) < 10 mmHg), three pairs of 30 s BP measurements with the OptiBP™ (test method) were simultaneously compared using three pairs of measurements with the non-invasive oscillometric brachial cuff (reference method) on the opposite arm over a period of four consecutive weeks at a rate of two measurements per week (one in the morning and one in the afternoon). The agreement of BP values between the two technologies was analyzed using Bland-Altman and error grid analyses. The performance of the smartphone application was investigated using the International Organization for Standardization (ISO) definitions, which require the bias ± standard deviation (SD) between two technologies to be lower than 5 ± 8 mmHg. Results: Among the 65 eligible volunteers, 53 participants had adequate OptiBP™ BP values. In 12 patients, no OptiBP™ BP could be measured due to inadequate signals. Only nine participants had known chronic arterial hypertension and 76% of those patients were treated. The mean bias ± SD between both technologies was -1.4 mmHg ± 10.1 mmHg for systolic arterial pressure (SAP), 0.2 mmHg ± 6.5 mmHg for diastolic arterial pressure (DAP) and -0.5 mmHg ± 6.9 mmHg for mean arterial pressure (MAP). Error grid analyses indicated that 100% of the pairs of BP measurements were located in zones A (no risk) and B (low risk). Conclusions: In a cohort of volunteers, we observed an acceptable agreement between BP values obtained with the OptiBPTM and those obtained with the reference method over a four-week period. The OptiBPTM fulfills the ISO standards for MAP and DAP (but not SAP). The error grid analyses showed that 100% measurements were located in risk zones A and B. Despite the need for some technological improvements, this application may become an important tool to measure BP in the future.

Detecting and Managing Childhood Onset Hypertension in Africa: A Call to Action

PURPOSE OF REVIEW

To review recent evidence on childhood hypertension across Africa, identifying knowledge gaps, challenges and priorities, and highlight clinical perspectives in managing primary hypertension.

RECENT FINDINGS

Only 15 of the 54 African countries reported on absolute blood pressure (BP) measures, elevated BP, pre- and/or hypertension. The reported hypertension prevalence ranged between 0.0 and 38.9%, while elevated BP and/or pre-hypertnesion ranged from 2.7 to 50.5%. Childhood BP nomograms are lacking across Africa and the rates of hypertension were based on guidelines developed in countries with the lowest to no number of children from African ancestry. The recent studies across Africa also showed little to no detail when reporting BP specific methodology. No recent data informing the use or effectiveness of antihypertensive agents in children and adolesents are available. Childhood hypertension is on the rise, while data from Africa remains vastly under-represented. Collaborative research, resources, and policies need to be strengthened in addressing the growing public health concern of childhood onset hypertension on this continent.

Accuracy of cuff blood pressure and systolic blood pressure amplification

Automated cuff measured blood pressure (BP) is the global standard used for diagnosing hypertension, but there are concerns regarding the accuracy of the method. Individual variability in systolic BP (SBP) amplification from central (aorta) to peripheral (brachial) arteries could be related to the accuracy of cuff BP, but this has never been determined and was the aim of this study. Automated cuff BP and invasive brachial BP were recorded in 795 participants (74% male, aged 64 ± 11 years) receiving coronary angiography at five independent research sites (using seven different automated cuff BP devices). SBP amplification was recorded invasively by catheter and defined as brachial SBP minus aortic SBP. Compared with invasive brachial SBP, cuff SBP was significantly underestimated (130 ± 18 mmHg vs. 138 ± 22 mmHg, p < 0.001). The level of SBP amplification varied significantly among individuals (mean ± SD, 7.3 ± 9.1 mmHg) and was similar to level of difference between cuff and invasive brachial SBP (mean difference -7.6 ± 11.9 mmHg). SBP amplification explained most of the variance in accuracy of cuff SBP (R2 = 19%). The accuracy of cuff SBP was greatest among participants with the lowest SBP amplification (ptrend < 0.001). After cuff BP values were corrected for SBP amplification, there was a significant improvement in the mean difference from the intra-arterial standard (p < 0.0001) and in the accuracy of hypertension classification according to 2017 ACC/AHA guideline thresholds (p = 0.005). The level of SBP amplification is a critical factor associated with the accuracy of conventional automated cuff measured BP.

A novel professional automated auscultatory blood pressure monitor with visual display of Korotkoff sounds: InBody BPBIO480KV validation according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard

OBJECTIVE

A novel automated auscultatory upper arm-cuff blood pressure (BP) monitor (InBody BPBIO480KV) for office use was developed. An electronic stethoscope embedded in the device cuff records the Korotkoff sounds, which are audible to the user and graphically displayed during cuff deflation. Automated BP measurements are provided, while allowing the user to assess the Korotkoff sounds. The device accuracy was tested using the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018) and its Amendment 1.2020-01.

METHODS

Participants were recruited to fulfil the age, sex, BP, arm circumference and cuff distribution criteria of the Universal Standard in general population using the same arm sequential measurement method. Three cuffs of the test device were used for arm circumference 23-28, 28-35 and 33-42 cm.

RESULTS

Data from 85 individuals were analysed [mean age 57.3 ± 15.0 (SD) years, 53 men, arm circumference 23-42 cm]. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings ( N  = 255) was 0.3 ± 5.5/0.6 ± 4.7 mmHg (systolic/diastolic; threshold ≤5 ± 8 mmHg). For criterion 2, the SD of the averaged BP differences per individual ( N  = 85) was 3.76/3.61 mmHg (systolic/diastolic; threshold ≤6.95/6.91 mmHg).

CONCLUSION

The InBody BPBIO480KV device for office use, which provides automated auscultatory measurements while reproducing and displaying the Korotkoff sounds, comfortably fulfilled the AAMI/ESH/ISO Universal Standard requirements in general population and can be recommended for clinical use. The assessment of Korotkoff sounds by healthcare professionals for evaluating the quality of automated measurements requires further evaluation.