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The extent and implications of sphygmomanometer calibration error in primary care

Journal of Human Hypertension volume 15, pages 587–591 (2001)Cite this article

Abstract

Aim: The sphygmomanometer is an essential piece of diagnostic equipment, used in many routine consultations in primary care. Its accuracy depends on correct maintenance and calibration. This study was designed to: (1) assess the maintenance and calibration of sphygmomanometers in use in primary care; (2) assess the clinical, ethical, legal and public health implications of our findings.

Method: A researcher assessed the accuracy of mercury and aneroid sphygmomanometers in use in 231 English general practices. He also made enquires about arrangements for the maintenance and calibration of sphygmomanometers. We conducted a small telephone survey in general practices across the country to determine maintenance and calibration arrangements across the country. We carried out a modelling exercise to explore the clinical, ethical and public health implications of our findings.

Results: Of 1462 sphygmomanometers, 9.2% gave readings were more than 5 mm Hg inaccurate. No practice had arrangements for maintenance and calibration of sphygmomanometers. Nationally, one of 54 practices had an arrangement for maintenance and calibration. True hypertension is very uncommon in women under 35, a blood pressure which is measured as high is much more likely to be caused by calibration error than by hypertension.

Conclusion: It is rare for sphygmomanometers used in primary care to be maintained and calibrated. Because of this women under 35 are at risk of misclassification and inappropriate treatment. This has ethical and public health implications. Clinicians using equipment which has not been maintained and calibrated may be medically negligent.

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References

  1. Specification for aneroid and mercury non-automated sphygmomanometers. BS2743: 1990, British Standards Institute, London

  2. Hussain A, Cox JG An audit of the use of sphygmomanometers Br J Clin Pract 1996 50 136–137

    CAS  PubMed  Google Scholar 

  3. Maskrey N, Parker C, Powell S THINYCE – Treating Hypertension Through Clinical Effectiveness in North Yorkshire, October 1998. North Yorkshire Clinical Advisory Service: North Yorkshire Health Authority

  4. Cranney M, Barton S, Walley T Auditing the management of hypertension in British general practice: a critical literature review Br J Gen Pract 1998 48 1424–1428

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Jones JS, Ramsey W, Hetrick T Accuracy of prehospital sphygmomanometers J Emergency Med 1987 5 23–27

    Article  CAS  Google Scholar 

  6. Hahn LP, Folsom AR, Sprafka JM, Prineas RJ Prevalence and accuracy of home sphygmomanometers in an urban population Am J Pub Health 1987 77 1459–1461

    Article  CAS  Google Scholar 

  7. Specification for Aneroid and mercury non-automated sphygmomanometers. BS2743: 1990, British Standards Institute, London

  8. Ramsay LE et alBritish Hypertension Society guidelines for hypertension management 1999: summary BMJ 1999 319 630–635

    Article  CAS  Google Scholar 

  9. Department of Health Health survey for England ’96 Stationery Office: London 1998

    Google Scholar 

  10. Reeves RA Does thispatient have hypertension? How to measure blood pressure J Am Med Assoc 1995 273 12118

    Article  Google Scholar 

  11. van de Mheen PJ, Bonneux L, Gunning-Schepers LJ Variation in reported prevalences of hypertension in The Netherlands: the impact of methodological variables J Epidemiol Community Health 1995 49 277–280

    Article  CAS  Google Scholar 

  12. McCarron P et alChanges in blood pressure among students attending Glasgow University between 1948 and 1968: analyses of cross sectional surveys BMJ 2001 322 885–889

    Article  CAS  Google Scholar 

  13. Anderson KA, Wilson PWF, Odell PM, Kannel WB An updated coronary risk profile. A statement for health professionals Circulation 1991 83 356–362

    Article  CAS  Google Scholar 

  14. Unwin N et alThe implications of applying widely accepted cholesterol screening and management guidelines to a British adult population: results from a cross sectional study of cardiovascular disease and risk factors BMJ 1998 317 1125–1130

    Article  CAS  Google Scholar 

  15. Department of Health Health survey for England ’98 Stationery Office: London 2000

    Google Scholar 

Download references

Acknowledgements

Thanks are due to Mr Brian Pritchard for carrying out the survey of sphygmomanometers.

Andrew Rouse obtained data on sphygmomanometer calibration error, made a crude estimate of the prevalence of misclassification error and contributed to writing the paper.

Tom Marshall developed models for estimating the prevalence of misclassification due to uncalibrated sphygmomanometer error and contributed to writing the paper.

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  1. Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

    A Rouse & T Marshall

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  1. A Rouse
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  2. T Marshall
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Correspondence to A Rouse.

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Rouse, A., Marshall, T. The extent and implications of sphygmomanometer calibration error in primary care. J Hum Hypertens 15, 587–591 (2001). https://doi.org/10.1038/sj.jhh.1001241

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