Comparison of manual and automated auscultatory blood pressure during graded exercise among people with type 2 diabetes
Open accessAbstract
Manual measurement of blood pressure (BP) during exercise testing is the recommended standard. Automated measurement of BP is an alternative method used during clinical exercise testing, but there is little data comparing manual and automated BP in this setting. The aim of this study was to determine the concordance between manual and automated BP during a standard clinical treadmill exercise test. 416 participants (66 ± 5 years; 54% male) completed a Bruce treadmill exercise test at baseline or follow-up within a clinical trial of participants with type 2 diabetes mellitus. Manual and automated BP were measured simultaneously at each exercise test stage. Manual BP was measured by a technician blinded to automated BP values (Tango+, Suntech). Concordance between manual and automated BP was assessed using mean differences and intraclass correlations (ICC). Concordance between manual and automated BP across all exercise stages was excellent for systolic BP (overall mean difference: 3 ± 11 mm Hg, P = .598; ICC = 0.964 [95% CI 0.942-0.977] and pulse pressure (overall mean difference: 2 ± 14 mm Hg, P = .595; ICC = 0.934 [95% CI 0.899-0.956]). Concordance between manual and automated diastolic BP across all exercise stages was moderate-to-good (overall mean difference: 1 ± 9 mm Hg, P = .905; ICC = 0.784 [95% CI 0.672-0.858]). Automated BP using the Tango + device is concordant with manual BP during early stages of a standard clinical exercise test. Thus, this automated method may be a suitable alternative to manual measurement of BP during clinical exercise testing.
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Automated, motion-tolerant devices in widespread clinical use have shown reasonable concordance with manual or invasive exercise BP measures.
“although there are automated, motion-tolerant devices in widespread clinical use that have shown reasonable concordance with manual or invasive exercise BP measures [47,48].”
From The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance (2022) · cites this paper as [47]
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(2020) · Journal of Clinical Hypertension · doi:10.1111/jch.13916
- Authors
- Moore, M. N., Picone, D. S., Callisaya, M. L., Srikanth, V., Sharman, J. E., & Schultz, M. G.
- Affiliations
- University of Tasmania (AU)
- Peninsula Health (AU)
- Corresponding author
- Schultz, Martin G.
- ORCID
- Venue
- The Journal of Clinical Hypertension
- Publisher
- Wiley
- Published
- 2019-10-22
- Volume
- 21
- Issue
- 12
- Pages
- 1872-1878
- ISSN
- 1524-6175 (ISSN-L)
- 1751-7176
- PMC
- PMC8030525
- OpenAlex
- W2981379212
- Cited by
- 9
- References
- 36
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2020: 1 · 2019: 1
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Update notices
- correction (2020-06-12)
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Hypertension (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UTAS Research Repository (submittedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by)
- Funders
- Alzheimer's Australia Research Foundation (CF13/3559)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- automated blood pressure measurement, manual blood pressure measurement, type 2 diabetes, treadmill exercise testing, Bruce protocol, systolic blood pressure, diastolic blood pressure, pulse pressure, measurement agreement
- MeSH terms
- Aged, Auscultation, Automation, Blood Pressure, Blood Pressure Determination, Diabetes Mellitus, Type 2, Exercise Test, Female, Humans, Hypertension, Male, Middle Aged, Oxygen Consumption, Sensitivity and Specificity, Exercise
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