More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective

Meir Nitzan,1 Itzchak Slotki,2 Linda Shavit2 1Department of Applied Physics/Electro-Optics, Jerusalem College of Technology, 2Department of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel Abstract: The commonly used techniques for systolic blood pressure (SBP) and diastolic blood pressure...

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Autores principales:	Nitzan M, Slotki I, Shavit L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Systolic blood pressure measurement oscillometry hypertension hypotension cognitive impairment photoplethysmography. Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/5b8f7ced36cb41e9930c50fbbb27e5d2
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spelling	oai:doaj.org-article:5b8f7ced36cb41e9930c50fbbb27e5d22021-12-02T02:44:18ZMore accurate systolic blood pressure measurement is required for improved hypertension management: a perspective1179-1470https://doaj.org/article/5b8f7ced36cb41e9930c50fbbb27e5d22017-07-01T00:00:00Zhttps://www.dovepress.com/more-accurate-systolic-blood-pressure-measurement-is-required-for-impr-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Meir Nitzan,1 Itzchak Slotki,2 Linda Shavit2 1Department of Applied Physics/Electro-Optics, Jerusalem College of Technology, 2Department of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel Abstract: The commonly used techniques for systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurement are the auscultatory Korotkoff-based sphygmomanometry and oscillometry. The former technique is relatively accurate but is limited to a physician’s office because its automatic variant is subject to noise artifacts. Consequently, the Korotkoff-based measurement overestimates the blood pressure in some patients due to white coat effect, and because it is a single measurement, it cannot properly represent the variable blood pressure. Automatic oscillometry can be used at home by the patient and is preferred even in clinics. However, the technique’s accuracy is low and errors of 10–15 mmHg are common. Recently, we have developed an automatic technique for SBP measurement, based on an arm pressure cuff and a finger photoplethysmographic probe. The technique was found to be significantly more accurate than oscillometry, and comparable to the Korotkoff-based technique, the reference-standard for non-invasive blood pressure measurements. The measurement of SBP is a mainstay for the diagnosis and follow-up of hypertension, which is a major risk factor for several adverse events, mainly cardiovascular. Lowering blood pressure evidently reduces the risk, but excessive lowering can result in hypotension and consequently hypoperfusion to vital organs, since blood pressure is the driving force for blood flow. Erroneous measurement by 10 mmHg can lead to a similar unintended reduction of SBP and may adversely affect patients treated to an SBP of 120–130 mmHg. In particular, in elderly patients, unintended excessive reduction of blood pressure due to inaccurate SBP measurement can result in cerebral hypoperfusion and consequent cognitive decline. By using a more accurate technique for automatic SBP measurement (such as the photoplethysmographic-based technique), the optimal blood pressure target can be achieved with lower risk for hypotension and its adverse events. Keywords: oscillometry, hypotension, cognitive impairment, photoplethysmographyNitzan MSlotki IShavit LDove Medical PressarticleSystolic blood pressure measurementoscillometryhypertensionhypotensioncognitive impairmentphotoplethysmography.Medical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 10, Pp 157-163 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Systolic blood pressure measurement oscillometry hypertension hypotension cognitive impairment photoplethysmography. Medical technology R855-855.5
spellingShingle	Systolic blood pressure measurement oscillometry hypertension hypotension cognitive impairment photoplethysmography. Medical technology R855-855.5 Nitzan M Slotki I Shavit L More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective
description	Meir Nitzan,1 Itzchak Slotki,2 Linda Shavit2 1Department of Applied Physics/Electro-Optics, Jerusalem College of Technology, 2Department of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel Abstract: The commonly used techniques for systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurement are the auscultatory Korotkoff-based sphygmomanometry and oscillometry. The former technique is relatively accurate but is limited to a physician’s office because its automatic variant is subject to noise artifacts. Consequently, the Korotkoff-based measurement overestimates the blood pressure in some patients due to white coat effect, and because it is a single measurement, it cannot properly represent the variable blood pressure. Automatic oscillometry can be used at home by the patient and is preferred even in clinics. However, the technique’s accuracy is low and errors of 10–15 mmHg are common. Recently, we have developed an automatic technique for SBP measurement, based on an arm pressure cuff and a finger photoplethysmographic probe. The technique was found to be significantly more accurate than oscillometry, and comparable to the Korotkoff-based technique, the reference-standard for non-invasive blood pressure measurements. The measurement of SBP is a mainstay for the diagnosis and follow-up of hypertension, which is a major risk factor for several adverse events, mainly cardiovascular. Lowering blood pressure evidently reduces the risk, but excessive lowering can result in hypotension and consequently hypoperfusion to vital organs, since blood pressure is the driving force for blood flow. Erroneous measurement by 10 mmHg can lead to a similar unintended reduction of SBP and may adversely affect patients treated to an SBP of 120–130 mmHg. In particular, in elderly patients, unintended excessive reduction of blood pressure due to inaccurate SBP measurement can result in cerebral hypoperfusion and consequent cognitive decline. By using a more accurate technique for automatic SBP measurement (such as the photoplethysmographic-based technique), the optimal blood pressure target can be achieved with lower risk for hypotension and its adverse events. Keywords: oscillometry, hypotension, cognitive impairment, photoplethysmography
format	article
author	Nitzan M Slotki I Shavit L
author_facet	Nitzan M Slotki I Shavit L
author_sort	Nitzan M
title	More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective
title_short	More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective
title_full	More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective
title_fullStr	More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective
title_full_unstemmed	More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective
title_sort	more accurate systolic blood pressure measurement is required for improved hypertension management: a perspective
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/5b8f7ced36cb41e9930c50fbbb27e5d2
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_version_	1718402162954862592

More accurate systolic blood pressure measurement is required for improved hypertension management: a perspective

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