Evaluation of the Efficiency of Indirect Blood Pressure Measurement Methods in Comparison to Intra-Arterial Reading among Iranian Individuals

Abstract

Background: Detecting the suitable non-invasive Blood Pressure (BP) measurement method is a quandary in clinical settings for accurate diagnosis of Hypertension (HTN) status. Objectives: This study aimed to evaluate the efficiency of indirect BP measurement methods in comparison to the gold standard among Iranian patients admitted for Coronary Angiography (CAG). Methods: This observational study was conducted on 150 CAG candidates randomly selected using the computerized random numbers from March 2019 to September 2019. The participants' BPs were measured via three different non-invasive methods, including brachial and wrist oscillometric cuffs plus brachial sphygmomanometer, and the results were compared to simultaneous intra-arterial reading as the gold standard. The associations between different non-invasive BP measurements and direct arterial BP reading were assessed using different statistical analyses, including correlation coefficient, chi-square, independent and paired t-test, and Analysis of Variance (ANOVA), as appropriated. Results: The mean age of the participants was 60.56 +/- 11.16 years. Both Systolic BP (SBP) and Diastolic BP (DBP) were positively correlated to the gold standard reading in all measurement methods (P < 0.001). After adjustment for potential confounders, the findings revealed no significant difference between the pre-defined BP measurement methods, including brachial sphygmomanometer, brachial oscillometric, and wrist oscillometric, and intra-arterial BP reading regarding the means of SBP and DBP (P > 0.05). Conclusions: The present study findings showed that the selected solution was appropriate in terms of clinical aspects for the patients undergoing CABG surgery with long surgical duration or low Ejection Fraction (EF) and reduced the costs to half. Considering the significant difference in the CK-MB level and the lower troponin level in the combined group (not statistically significant), further studies are required to confirm the clinical priority of the combined solution.