Iftekhar Ahmad, Shahina Qayyum, Ifttekhar Ahmad, Rana Qamar, Mustafa Chagani.
Sphygmomanometers in clinical use: are they reliable?.
Pak Heart J Jan ;42(1):27-30.

Introduction: Hypertension affects approximately 1 billion individual worldwide. It is responsible for 7.1 million premature deaths and 4.5% of disease burden. Higher the BP, the greater is the chance of heart attack, heart failure, stroke, and kidney disease. The management of Hypertension depends on stage of Hypertension which is determined by measurement of systolic and diastolic blood Pressure. Accurate assignment of blood pressure status is crucial from a public health standpoint. Overestimating or underestimating blood pressure by even 5 mm Hg can mislabel over 20 million persons as having high normal blood pressure rather than hypertension; conversely, another 20 to 30 million could be misclassified as hypertensive exposing these persons to the expense and adverse effects of treatment. Different type of Blood pressure instruments (sphygmomanometer) like mercury and aneroid type are generally used in our country. What ever the type for accurate measurement of blood Pressure properly calibrated and validated instrument should be used. Objective: To determine the frequency of errors in Blood pressure instruments (sphygmomanometer) in use in different health care facilities Material and Method: Inclusion: All working BP apparatus used in different health facilities Exclusion: Damaged or out of order instruments Method: Blood pressure instruments (sphygmomanometer) in use in different health care facilities were randomly tested on-site with ERKA Made In Germany Model No 83646 BAD Tötz Name of the facility where BP apparatus is used, designation of the user, the type of BP instrument, make of the instrument and error if any was recorded. Any difference of more than 5 mm mercury was taken as an error as recommended. Results: 501 BP apparatuses were tested. All of them were in use. Out of these 252 (50.3%) were being used in teaching hospitals. 48.5% were mercury manometers most of the instrument were purchased six months earlier. Error was present in 30.1% of instruments in use. It was observed in 45.73% of aneroid type of BP apparatus and 13.58% of mercury type of BP apparatus. Difference range from 0 to 70 mm mean 4.73 SD 8.313. Error was more in aneroid type of BP apparatus (p= .001) Error was significantly more in older instrument (p=.001) Non of the instruments was calibrated. Conclusion: It is recommended that Blood pressure instruments should be regularly calibrated.

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