Analysis Of Application Of Electronic Sphygmomanometer And Mercury Sphygmomanometer In Elderly Patients With Essential Hypertension

Objective:Comparing the differences of electronic sphygmomanometer and mercury sphygmomanometer in elderly patients with essential hypertension,to provide basis for the standards of blood pressure measurement on clinic.Methods:A total of 143 patients(60-80 years old)with essential hypertension(EH)and 127 patients(60-80 years old)with normal blood pressure were selected from June 2017 to February 2018 in hypertention clinic and inpatient Dpartment of Cardi-ology Dep.3 of the Second Affiliated Hospital of Kunming Medical University.Col-lecting their gender,age,smoking,body mass index(BMI)and other general inform-ation.Recording inter ventricular septal thickness(IVST),left ventricular diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT)of ultrasound cardiogram(UCG),ankle brachial index(ABI),brachial ankle pulse wave velocity(baPWV),triglycerides(TG),total cholesterol(T-CHO),low density lipoprotein-cholesterol(LDL-C),serum uric acid(SUA),creatinine(CR),fasting plasma glucose(FPG),urine microalbumin(MA)and other laboratory index.Measuring Blood pre-ssure 5 times continuously on the double upper arm of each subject with an electronic sphygmomanometer and a mercury sphygmomanometer successively,and reading the value of systolic blood pressure(SBP),diastolic blood pressure(DBP)with an elec-tronic sphygmomanometer and SBP,the 4th(changing sound),the 5th(disappearing sound)korotkoff sound with a mercury sphygmomanometer.Comparing the differe-nces in blood pressure values measured by the two sphygmomanometers.Results:(1)Comparing the SBP and DBP measured by the two sphygmomanometers.There was a positive correlation between the SBP(r>0,p<0.05),the difference has no statistica significance(p>0.05),and the DBP was also;the Intra-Class Correlation Coefficients(ICC)of the SBP,DBP>0.8;more than 95%scatters were within the Limits of Agreement(LoA)in all Bland-Altman plots;the average deviation and standard deviation of the SBP were less than the national standard(average deviation<±5mmHg,standard deviation<8mmHg),and the DBP was also.(1mmHg=0.133kPa).(2)The diastolic blood pressure measured with the electronic sphygmomanometer were lower than that measured by the 4th korotkoff sound with a mercury sphygmomanometerby,the difference has no statistical significance(p>0.05),and were significantly higher than the values measured by the 4th korotkoff sound,the difference has statistical significance.(p<0.05).The variation of the values of blood pressure measured by the 4th korotkoff sound were less than that of the 5th.(3)The five values of blood pressure measured by two sphygmomanometers gradually decreased.The first values were high.the middle three values were stable(p>0.05),and the difference between the fourth and fifth value has statistical significance(p<0.05).The 5th values had a tendency to increase compared with the middle 3 times.(4)Analyzing the methods of calculating the first three values of blood pressures.The average values obtained after removing the first values and the average values of the three blood pressure values were same(p<?').(5)In the hypertension group,as for the values of SBP measured with two sphygmomanometers:left arm>right arm,the difference has statistical significance(p<0.05);as for the values of DBP measured with an electronic sphygmomanometer and blood pressure measured by the 4th korotkoff sound with a mercury sphygmomanometer:left arm<right arm,the difference has no statistical significance(p>0.05).As for the values in non-hypertension group:left arm>right arm.(6)The T-CHO,LDL,C,SUA,CR,urine MA,LVDd,IVST,LVPWT,ABI,baPWV in hypertension groupwere were higher than those in the non-hypertension group(p<0.05).There were no statistical difference of FPG,TG between two group.Conclusions:(1)In elderly hypertensive patients,the values of blood pressure between the electronic sphygmomanometer and the mercury sphygmomanometer were highly consistent,and the electronic sphygmomanometer was reliable.(2)When measuring the blood pressure with a mercury sphygmomanometer in elderly hypertensive patients,the values of blood pressure measured by the changing sound should be taken as the standard of diastolic blood pressure.(3)The values of blood pressure in the left arm may were higher than those in the right arm,and we should take the higher side as the standard.(4)The appropriate number of measuring blood pressure is 3 to 4 every time in elderly hypertensive patients.If measuring 3 times,the difference between the average values of blood pressure obtained after removing the first time and the average values of three values has no statistical difference.(5)T-CHO,SUA,and LDL-C were risk factors for hypertension.Hypertension was a risk factor for cardiovascular target organs damage.