Concurrent validity studies of blood pressure instrumentation. The Philadelphia Blood Pressure Project.

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Abstract
There is increasing evidence that blood pressure (BP) screening during adolescence may detect early evidence of hypertensive disease. Choice of instrumentation becomes important to maximize the accuracy and interpretive value of several serial readings. We therefore conducted two studies of adolescents, comparing auscultatory (Baumanometer and Random-zero), ultrasonic (Arteriosonde 1216), and infrasonic (Physiometrics SR-2) devices. These instruments were compared serially (Study 1) for older adolescents (n = 48). The Baumanometer, Arteriosonde 1216, and Physiometrics SR-2 were compared both serially and simultaneously (Study 2) for younger and older adolescents (n = 24). In both studies, the order of device presentation was completely counterbalanced. In Study 1, reliability estimates were high (r greater than 0.65), with the exception of the Arteriosonde 1216 diastolic readings, and the Physiometrics SR-2 yielded significantly lower mean diastolic BP readings than the other devices. Diastolic Phase V readings taken with the Random-zero were significantly higher when the Random-zero was presented at the end of the sequence of instrument presentation. This order of presentation effect is probably attributable to the need for overinflation when using the Random-zero device and may cause an overestimation of diastolic BP in the young. In Study 2, again the Arteriosonde 1216 did not perform reliably in recording diastolic BP. Further, the Physiometrics SR-2 device, although reliable, yielded diastolic readings significantly lower (p less than 0.001) than diastolic Phase IV readings taken both serially and simultaneously.(ABSTRACT TRUNCATED AT 250 WORDS)