Skip to main content
Log in

Are Automated Blood Pressure Monitors Accurate Enough to Calculate the Ankle Brachial Pressure Index?

  • Published:
Journal of Clinical Monitoring and Computing Aims and scope Submit manuscript

Abstract

Objective

Conventional sphygmomanometers are being replaced by automated devices; can they be used to accurately calculate ABPI?

Method

Thirty-six volunteers (72 legs) attending a vascular clinic had their ankle, brachial blood pressure and ABPIs calculated using each of these 3 methods. (1) Conventional aneuroid BP cuff with hand held doppler. (2) OMRON HEM 705CP portable automated BP monitor. (3) The hand held doppler to determine systolic BP measured by the OMRON.

Results

Conventional doppler readings for brachial and ankle pressures were generally higher than those obtained digitally by less than 3 mmHg but this was not statistically significant. This did not translate into a significant difference in ABPIs obtained using all 3 techniques; the correlation coefficient of conventional ABPI with automated ABPI (method 2) was 0.746, this was improved to 0.899 using method 3. The OMRON failed to detect a signal in 16 of the 72 legs, 11 of these legs had ABPIs <0.66.

Conclusion

Conventional doppler measurements give higher readings for systolic blood pressure but there is no significant difference when calculating ABPI. A normal digital ABPI excludes significant vascular disease and a low digital ABPI indicates disease. If no blood pressure is recordable a doppler should be used to confirm the true result. Automated oscillometric BP monitors may be used to accurately measure ABPI in non-diabetics in the community without teaching clinicians to use a doppler, thus removing observer error. This may be of particular use in the community to exclude significant arterial disease in venous ulcer patients and assess general cardiovascular risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. O’Brien E, Waeber B, Parati G, Staessen J, Myers MG. Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 2001;322(7285):531–536.

    Article  PubMed  CAS  Google Scholar 

  2. Park MK, Menard SW, Yuan C. Comparison of auscultatory and oscillometric blood pressures. Arch Pediatr Adolesc Med 2001;155(1):50–53.

    PubMed  CAS  Google Scholar 

  3. Amoore JN. A simulation study of the consistency of oscillometric blood pressure measurements with and without artefacts. Blood Press Monit 2000;5(2):69–79.

    PubMed  CAS  Google Scholar 

  4. Carter SA. Clinical measurement of systolic pressures in limbs with arterial occlusive disease. JAMA 1969, 207(10):1869-&.

    Google Scholar 

  5. de Graaff JC, Ubbink DT, Legemate DA, de Haan RJ, Jacobs MJ. Interobserver and intraobserver reproducibility of peripheral blood and oxygen pressure measurements in the assessment of lower extremity arterial disease. J Vasc Surg 2001;33(5):1033–1040.

    Article  PubMed  Google Scholar 

  6. Jeelani NUO, Braithwaite BD, Tomlin C, MacSweeney ST. Variation of method for measurement of brachial artery pressure significantly affects ankle-brachial pressure index values. Eur J Vasc Endovasc Surg 2000;20(1):25–28.

    Article  PubMed  CAS  Google Scholar 

  7. Kaiser V, Kester AD, Stoffers HE, Kitslaar PJ, Knottnerus JA. The influence of experience on the reproducibility of the ankle brachial systolic pressure ratio in peripheral arterial occlusive disease. Eur J Vasc Endovasc Surg 1999;18(1):25–29.

    Article  PubMed  CAS  Google Scholar 

  8. Ray SA, Srodon PD, Taylor RS, Dormandy JA. Reliability of ankle-brachial pressure index measurement by junior doctors. Br J Surg 1994;81(2):188–190.

    Article  PubMed  CAS  Google Scholar 

  9. Fisher CM, Burnett A, Makeham V, Kidd J, Glasson M, Harris JP. Variation in measurement of ankle-brachial pressure index in routine clinical practice. J Vasc Surg 1996;24(5):871–875.

    Article  PubMed  CAS  Google Scholar 

  10. Fowkes FG, Murray GD, Butcher I, Heald CL, Lee RJ, Chambless LE, et al. Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA 2008;300(2):197–208.

    Article  PubMed  CAS  Google Scholar 

  11. White R. A new standard for the nursing assessment of leg ulcers. Br J Nurs 1999;8(19):1272–1279.

    PubMed  CAS  Google Scholar 

  12. Elliot E, Russell B. Setting a standard for leg ulcer assessment. J Wound Care 1996;5(6):173–175.

    PubMed  CAS  Google Scholar 

  13. Mundt KA, Chambless LE, Burnham CB, Heiss G. Measuring ankle systolic blood-pressure—validation of the Dinamap 1846sx. Angiology 1992;43(7):555–566.

    Article  PubMed  CAS  Google Scholar 

  14. Adiseshiah M, Cross FW, Belsham PA. Ankle blood-pressure measured by automatic oscillotonometry—a comparison with Doppler pressure measurements. Ann R Coll Surg Engl 1987;69(6):271–273.

    PubMed  CAS  Google Scholar 

  15. Lee BY, Campbell JS, Berkowitz P. The correlation of ankle oscillometric blood pressures and segmental pulse volumes to Doppler systolic pressures in arterial occlusive disease. J Vasc Surg 1996;23(1):116–122.

    Article  PubMed  CAS  Google Scholar 

  16. Blebea J, Ali MK, Love M, Bodenham R, Bacik B. Automatic postoperative monitoring of infrainguinal bypass procedures. Arch Surg 1997;132(3):286–291.

    PubMed  CAS  Google Scholar 

  17. Ramanathan A, Conaghan PJ, Jenkinson AD, Bishop CR. Comparison of ankle-brachial pressure index measurements using an automated oscillometric device with the standard doppler ultrasound technique. Anz J Surg 2003;73(3):105–108.

    Article  PubMed  Google Scholar 

  18. Obrien E. Accuracy of the Dinamap 8100. Am J Hypertens 1997;10(1):143–144.

    Article  CAS  Google Scholar 

  19. Obrien E, Atkins N. Inaccuracy of the Dinamap 8100 portable monitor. Lancet 1997;349(9057):1026–1026.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Euan MacDonald BSc, MBChB, MRCS.

Additional information

MacDonald E, Froggatt P, Lawrence G, Blair S. Are automated blood pressure monitors accurate enough to calculate the ankle brachial pressure index?

Rights and permissions

Reprints and permissions

About this article

Cite this article

MacDonald, E., Froggatt, P., Lawrence, G. et al. Are Automated Blood Pressure Monitors Accurate Enough to Calculate the Ankle Brachial Pressure Index?. J Clin Monit Comput 22, 381–384 (2008). https://doi.org/10.1007/s10877-008-9146-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10877-008-9146-8

Key words

Navigation