Agreement of aneroid and oscillometric blood pressure devices used in pregnancy

Objectives: The objective of this study was to compare three automated blood pressure devices (Microlife VSA, Uscom BP+ and Tensiomed Arteriograph)with an aneroid device in an Australian antenatal population to determine an accurate and reliable alternative method of measuring blood pressure in pregnant women. Study design: This observational, prospective study recruited a random sample of 200 pregnant women of any gestation attending an antenatal clinic in an Australian hospital. Each participant had two peripheral blood pressure measurements per instrument performed, resulting in eight measurements per participant. Main outcome measurements: Intra- and inter-device reliability of peripheral blood pressure measurements made by the aneroid device and the three automated brachial-cuff oscillometric devices were assessed. The agreement between devices was graded according to standardised criteria. Results: Both intra- and inter-device reliability of blood pressure measurements of the four devices in this study were found to be ‘excellent’ (ICCs > 0.75). Microlife VSA and Uscom BP+ showed acceptable levels of agreement (±5mmHg)when compared to the aneroid device. Arteriograph did not show an acceptable level of agreement with the aneroid device for systolic blood pressure, but did for diastolic blood pressure. Conclusion: Accurate automated devices may ensure consistent assessment of blood pressure in the antenatal setting. Our results suggest that Microlife VSA and Uscom BP+ may be suitable alternatives to the aneroid device for use in the antenatal setting. Further studies assessing both auscultatory and oscillometric blood pressure devices in pregnancy, and especially in hypertensive cohorts, are required.