Blood pressure changes associated with tilting in normotensive subjects: differences in response pattern as measured by oscillometry and auscultation

Abstract

Three non-invasive instruments were used to measure blood pressure in the supine position and on tilting--a conventional and a random-zero sphygmomanometer, and an oscillometric device (Accutorr 1A). Twenty normotensives volunteered for the study. There was no statistically significant difference in systolic blood pressure and diastolic blood pressure measured by the conventional and random-zero sphygmomanometers in the supine position. There was a difference between these recordings and those of the Accutorr, with the Accutorr giving higher readings of systolic blood pressure (p less than 0.001), analysis of variance, 95% confidence interval of the difference between the Accutorr and the random-zero was 5.1-15.7 mmHg) and lower readings of diastolic blood pressure (p less than 0.0001, analysis of variance, 95% confidence interval of the difference between the Accutorr and the random-zero was -12.2- -2.2 mmHg). On tilting, the Accutorr showed an increase in systolic blood pressure while the other two machines did not (p less than 0.01, analysis of variance). By contrast, the Accutorr detected a smaller rise in diastolic blood pressure than with the other two instruments (p less than 0.05, analysis of variance). The difference between blood pressure measurements made in the supine position by the two different techniques, auscultation and oscillometry, might be expected. However, the two different techniques do not detect the same blood pressure responses to a change in posture.