The first commercial automated BPMD, the Device for Indirect Non-invasive Automatic Mean Arterial Pressure (DINAMAP) 825, became available in 1976 and was incorporated into both research and clinical practice. Consequent efforts were directed towards the development of automated BP measuring devices (BPMDs) based on electronic capture and analysis of pressure waveforms in the cuff, and were specifically designed to provide BP values equivalent to the systolic and diastolic BP values measured with a mercury sphygmomanometer. Automation of BP measurement became favoured over manual methods to lessen the chances of user error from such things as digit preference, observer bias, incorrect stethoscope placement and failing to correctly interpret Korotkoff sounds, to name a few. Manual auscultatory measurement of upper arm blood pressure (BP) with a mercury sphygmomanometer was the gold standard non-invasive test and mainstay clinical method to diagnose hypertension in the twentieth century This indirect measurement method, as well as automated BP methods, was used in the ground-breaking epidemiological and clinical trials that discovered the importance of high BP as a cardiovascular disease risk factor, as well as the value of antihypertensive treatment to reduce cardiovascular events and mortality. While there is room for future refinement to improve accuracy for better individual risk stratification, validated BPMDs remain the recommended standard for office and out-of-office BP measurement to be used in hypertension diagnosis and management worldwide. Much of the work to derive contemporary BP thresholds and treatment targets used to manage cardiovascular disease risk was obtained using automated BPMDs. Validated automated BPMDs provide similar BP values to those recorded using manual auscultation albeit with potential sources of error mostly associated with using empirical algorithms to derive BP from waveform pulsations. Currently, there are many thousands of unique automated BPMDs manufactured by hundreds of companies, with each device using proprietary algorithms to estimate BP and using a method of operation that is largely unchanged since inception. Automated BPMDs that have passed accuracy testing versus a reference auscultatory sphygmomanometer using a scientifically accepted validation protocol are recommended for clinical use globally. ![]() ![]() Automated ‘oscillometric’ blood pressure (BP) measuring devices (BPMDs) were developed in the 1970s to replace manual auscultatory BP measurement by mercury sphygmomanometer.
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