(Hypertension. 1995;26:307-314.)
© 1995 American Heart Association, Inc.
Articles |
Physiological Influences on Continuous Finger and Simultaneous Intra-arterial Blood Pressure
From the Cardiovascular Research Unit, Department of Cardiology, Royal North Shore Hospital, St Leonards (Sydney), NSW, Australia.
Correspondence to Prof Stephen N. Hunyor, Cardiovascular Research Unit, Department of Cardiology, Royal North Shore Hospital, St Leonards (Sydney), NSW 2065, Australia. E-mail crcctozemail.com.au.
Abstract Because of the clinical and experimental utility of
continuous finger blood pressure measurements and the need for
accuracy, we tested the performance of a new hydraulic device
in 22 consecutive hypertensive subjects during
physiological and pharmacological interventions.
Ipsilateral brachial intra-arterial pressure was monitored
during rest, Valsalva's maneuver, static handgrip, and mental
arithmetic and after sublingual glyceryl trinitrate. In excess of
40 000 blood pressure values were analyzed. Average bias
(intra-arterial minus finger blood pressure) was 8.2±17.0
mm Hg (mean±SD, P=NS) for systolic and 2.8±10.4 mm Hg
(P=NS) for diastolic pressure. Two-way ANOVA of
biases with subject and task factors showed a subject effect
(P<.001). Intersubject and intrasubject standard deviations
of bias were 13.8 and 9.8 mm Hg systolic and 8.7 and 5.7
diastolic, respectively. Linear drift (millimeters of
mercury per minute) of finger pressure was greater (P<.001)
for systolic than diastolic pressure during static exercise
and math and after glyceryl trinitrate. Coefficients of determination
for blood pressure ranged from 0.4±0.3 to 0.8±0.3 during the tasks.
We conclude that (1) noninvasive finger blood pressure faithfully
follows intra-arterial changes but with clinically relevant
offsets, (2) this technique is best suited for assessing pressure
changes, (3) physiological and pharmacological
interventions do not consistently affect finger pressure
accuracy, (4) many reports of finger blood pressure measuring devices
are based on direct readings obtained with inadequate system response
characteristics, and (5) the tested instrument falls short of the
standards requirements (bias 
5±8 mm Hg) for devices that measure
intermittently.
Key Words: bias • Valsalva's maneuver • blood pressure monitoring
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