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Abstract: PO1780

Oscillometric vs. Auscultatory Blood Pressure Measurements and the Impact of Atrial Fibrillation

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Aburahma, Ahmed, Cooper University Health Care, Camden, New Jersey, United States
  • McFadden, Christopher B., Cooper University Health Care, Camden, New Jersey, United States
Background

The Hypertension literature recognizes a difference in Oscillometric Blood pressures compared to Auscultatory Blood pressure measurements. Theses differences are small but increased in patients with Atrial fibrillation.This difference varies in previous studies. Again this Difference is larger in subjects with atrial fibrillation.
Current Blood pressure measurement guidlines emphasize the use of an Auscultatory method or repeated oscillometric measures to measure blood pressure in patient with arrythmias including atrial fibrillation.This recommendation is not consistently implemented in clinical medicine.We aim to quantify the differences in blood pressure readings between oscillometric and auscultatory method and correlate that to presence or absence of atrial fibrillation.

Methods

This is a retrospective study that involved adult patients seen in the outpatient nephrology clinic by one of the investigators (CM) between january 2016 and january 2020.Data collection included age , sex, BMI, atrial fibrillation (AF), CKD stage, diabetes mellitus ,blood pressure readings ( by both methods, which were done by the investigator (CM) in all antihypertensive patients) and number of blood pressure medications.
Information on a total of 200 patients were collected. 100 of those had hypertension with AF while the other 100 had hypertension but no AF to achieve a power of 80% and P value of 0.05.

Results

After using Unpaired t test, the average difference between two methods in hypertensive patient without atrial fibrillation were around 0.29 mmHg in systolic blood pressure (P value of 0.9 and 95% CI from -5.5 to 6.12) and 5.39 mmhg in diastolic blood pressure (P value of 0.0068 and 95% CI from 1.5 to 9.24) .
On the other hand , the average difference between two methods in hypertensive patients with atrial fibrillation were 6.8 mmHg in systolic blood pressure ( P value of 0.018 and 95% CI from 1.18 to 12.5 ) and 5.04 mmHg in diastolic blood pressure (P value of 0.002 and 95% CI from 1.87 to 8.21).

Conclusion

This study showed a statistical difference between the two methods in measuring the blood pressure of hypertensive patients with atrial fibrillation. A larger study is needed to show the no difference between the two methods . For now we need to encourage the use of auscultatory method in measuring the Blood pressure in this group of patients .