Measuring Blood Pressure: Accuracy and Significance

From the discussion, it can be said that right measurement of blood pressure is very necessary in care settings
as it helps early diagnosis and management of hypertension. It is recommended use of manual blood pressure
measurement device helps the care professionals in getting more accurate readings in comparison to
automated blood pressure monitor. The should use manual sphygmomanometer in order to reducing the
chances of errors and preventing the people with other diseases like heart attack, kidney failure, dementia,
stroke etc. Apart from this, people should ensure proper monitoring of blood pressure on regular basis in order
to avoid other diseases associated with it and living a healthy life.
The clinical review in accurate diagnosis of hypertension?” The question is
developed bquestion in relation to this research is “In people with hypertension, how
effective manual sphygmomanometer is in comparison to automated blood pressure
measurement y using PICO format as provides a proper criterion to develop the
question of research. Utilization of PICO approach makes it easy to search for
answer. The four elements of which are as follows:
Hypertension is one of the leading Public Health issue that affecting the entire world so its
accurate measurement is very necessary for early diagnosis and management. It is very
important images of blood pressure accurately as inaccuracy in the readings may leads to
create some other health issues. Hypertension is a chronic condition and occurs when the
force of blood pushing against walls of blood vessels is high. This also increases the risk of
heart attack, stroke and heart diseases.
Purpose and significance of project:
The main purpose of the project is
“to assess the effectiveness of manual sphygmomanometer in comparison to automated
blood pressure measurement in accurate diagnosis of hypertension”.
 It helps in determining the effectiveness of manual blood pressure monitoring over
automatic blood pressure measurement. It is significant in gaining knowledge and deep
insights regarding the topic along with the other areas associated with the topic (Kario Thijs
& Staessen, 2019).
This project is highly significant in understanding the significance of accuracy in blood
pressure measurement readings for care practitioners.
In order to gather data on the clinical review question, the data bases like PubMed
database and NCBI are used. Apart from this, the search strategy used includes
Boolean operators such as 'AND' and 'OR' are used for narrowing down the search
outcomes.
 For including relevant outcomes only, the keywords like manual sphygmomanometer
AND automated blood pressure monitor etc. are use.
 In order to expand the results of search, Boolean operator like OR is use so that
outcomes should involve the defined keywords as well as phrases.
 In addition to this, some keywords are also used in order to search data or
information related to question includes hypertension, blood pressure, mercury
manometer etc. Moreover, in order to narrow down the results, the search filters such
as publication date, language, publication type, subject etc. are used.
 Apart from this, the inclusion and exclusion criteria is considered at the time of
developing search strategy as well as searching date or information on the clinical
review question (Leung and et. al., 2016).
 The data from last five years is included and collection of reliable information is
ensured by using authenticated sources only.
Measuring of Blood Pressure
Student name:
ID:
Background Search strategy Recommendation
Clinical Review Question
The accuracy in blood pressure reading in health care settings is one of the main concern despite
of promotion of measurement techniques. Manual blood pressure measurement can be accurate
when utilizing device like mercury manometer. 90/60 and 120/80 is considered as a healthy blood
pressure reading and the reading 140/90 and above is considered as high blood pressure, that
could be diagnosed as hypertension. It is one of the leading cause of heart related diseases which
can lead to kidney failure, stroke, heart attack and dementia. However, if the measure of blood
pressure is below 90/60, then it can be indicated as low blood pressure or hypotension which can
outcome in fainting, dizziness, and long-term damage to brain and heart. The high or low blood
pressure reading in an adult can be alarming due to associated risks. However, there are numerous
factors which can lead to temporary drop or spike in blood pressure which leads to false reading.
Some of the factors are discussed below:
• Stress and anxiety: if a person is experiencing stress before or during measuring blood pressure,
the spike in levels of cortisol can cause increase in heart rate and could resulted into high reading
of blood pressure. Apart from this, can anxiety cause because of being at doctor's clinic, referred
as white coat hypertension and can also cause rise in blood pressure.
• Crossed legs: crossing the legs at the time of measuring blood pressure can increase the results by
2 to 5 points. So, it is very necessary to ensure that a person sits with legs uncrossed as well as
feet flat on ground at the time of measuring blood pressure.
• Eating: right after eating food or meal, the blood pressure reading will often lower than normal
due to digesting food actually lowers the pressure of blood. If the blood pressure measurement is
taken at home, then it is recommended by doctor to take the test in morning before having
breakfast or after 30 minutes of meal. Apart from this, fasting or not eating enough can also cause
inaccurate reading (Turner, Viera & Shimbo, 2015).
All the above mentioned factors requires to be consider by an individual at the time of measuring
blood pressure.
It is very necessary to get an accurate blood pressure reading as it is called silent killer as there
are no symptoms and signs of high blood pressure. If the blood pressure is too low or too high,
then it will be dangerous to a person. It is commonly measured through inflating a cuff on upper
arm of a person and watching the pressure indicated through blood pressure gauge at the time of
listening to korotkoff sounds at brachial artery with stethoscope. For a healthy adult human, the
typical values are around 120 mmHg systolic and 80 mmHg diastolic. As a part of natural
circadian rhythm, blood pressure differs throughout the day.
 The factors like drugs, stress, smoking, nutrition and disease also effect the reading of blood
pressure. In early 1900s, the physicians ascertained that high blood pressure is a risk related to
early death because of coronary heart disease.
 Even a small increase or decrease in blood pressure may impact on body thus, measuring
accurate blood pressure is very necessary. However, it is not easy to measure the blood pressure
accurately. The accuracy of each measurement device varies widely (Accurate Blood Pressure
Measurement, 2016)..
For the blood pressure measurement, Mercury manometer is recommended as instrument of
choice. However, even with perfectly calibrated manometer, the American Heart Association
cautions practitioners regarding common sources of errors in manual measurement. With the
potential obstacles to accurate blood pressure measurement manually, one might think that
 The automatic blood pressure monitoring device would be preferred. In United States, the
certification of medical devices is the responsibility of FDA (food and drug association). It
depends upon voluntary compliance through manufacturers to a standard developed through
association for the advancement of medical instruments. However, absence of this certification
doesn't prevent sale of non-certified blood pressure mountain instrument to individuals, clinics
and hospitals. Today, most of the hospitals or clinics utilise automated blood pressure instruments
to collect readings. However, also keep a manual sphygmomanometer available for the times
when reading cannot be obtained or in doubt through automatic metres.
 The physicians are more possibly to utilise manual sphygmomanometer, but are adopting
automated devices increasingly interest of efficiency. A device would be an ideal product when it
is combined the best of both - the accuracy and reliability of mercury manometer with the
automated technique and speed of monitor (Bauer, and et. al., 2018).
 For right estimation of blood pressure in non-invasive setting, manual sphygmomanometer is
considered as appropriate device. However, the fear of precious effect of toxicity of potential
Mercury and issues related to disposal of Mercury, has led to decline in use of mercury
instruments all over the world. The digital blood pressure monitors have replaced the utilization
of traditional Mercury instruments in many settings.
 A study depicts that the percent distribution of absolute differentiations in the readings between
non mercury and mercury devices separately within 0 - 3, 4 - 6, 6 - 10, 11 - 15 and 16 + mmHg
categories. For acceptance of accuracy of device with respect to gold standard device, absolute
agreements within 5 mmHg is seen as accepted threshold.
 The manual measurement of blood pressure, especially with mercury sphygmomanometer has
been utilized for over 100 years. Concerning to advances in blood pressure monitoring methods,
mercury method is seeming to be removed from health care settings, nevertheless, mercury
sphygmomanometer keep available as a reference standard till an alternative instrument will be
recognized.
 A study comparing manual method with automated blood pressure measurement have depicted
that manual method of blood pressure monitoring has more levels (Comparison of manual versus
automated blood pressure measurement, 2017). Thus, it can be said that in comparison to
automatic measurement, manual method of blood pressure measurement is more effective.
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Bauer, F., and et. al., (2018). Attended versus unattended blood pressure measurement in a real life
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Kario, K., Thijs, L., & Staessen, J. A. (2019). Blood pressure measurement and treatment decisions: Masked and white-coat
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Online
FACTORS THAT CAN EXAGGERATE BLOOD PRESSURE READINGS, 2019. [Online]. Available through:
<https://cvgcares.com/factors-that-can-exaggerate-blood-pressure-readings/>
Accurate Blood Pressure Measurement: What It Is, Why It’s Important, and How to Ensure Reliable Results, 2016.
[Online]. Available through: <https://www.adctoday.com/sites/default/files/adview2/lit/Accurate%20Blood%20Pressure
%20Measurements.pdf>
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<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515188/>
Synthesis of Current
Evidence
References
Population People with hypertension
Intervention Manual sphygmomanometer
Comparison Comparison between manual
sphygmomanometer and automated blood
pressure monitor
Outcome Accurate diagnosis of hypertension