Clinical decision-making in hypertension using an automated (BpTRU™) measurement device

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Abstract
Mercury sphygmomanometers are being removed from clinical practice in the United States due to environmental concerns about mercury toxicity. Accurate blood pressure measurement is central to high-quality hypertension management. In this study of 106 patients, the BpTRUTM device was compared to nurse blood pressure measurements that complied with all the JNC VII/American Heart Association guidelines in evaluation of a random casual blood pressure. The intermethod difference in systolic blood pressure was +1.85.1 mmHg, and for diastolic blood pressure it was 4.85.1 mmHg (both P<0.001). For the primary study end point of clinical decision-making, there was 92% (97/106) agreement between the hypertension nurse specialist and the BpTRU™ (kappa 0.8280, 95% confidence interval, 0.721–0.9350). The oscillometric blood pressure measurement with the BpTRU™ is recommended as a replacement for poorly performed auscultatory blood pressure measurement in clinical practice.