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To The Editor: Dr Jones and colleagues¹ stated that indirect blood pressure measurement using oscillometric technique was based on measurement of mean arterial pressure, in which systolic and diastolic components are calculated according to an empirically derived algorithm. However, oscillometric devices may attempt to determine diastolic (and sometimes systolic) pressure values by analysis of the oscillometric waveform as the cuff pressure declines.² Another potential source of error of this method involves the effect of the rate of deflation relative to the heart rate.³ If the deflation rate is too rapid or the heart rate is too slow (eg, in patients receiving -blockers), the oscillometric device will be unable to make an accurate determination.³

Karim Bendjelid, MD, MS
Surgical Intensive Care Division
Hôpitaux Universitaires de Genève
Genève, Switzerland

1. Jones DW, Appel LJ, Sheps SG, Roccella EJ, Lenfant C. Measuring blood pressure accurately: new and persistent challenges. JAMA. 2003;289:1027-1030. FREE FULL TEXT 2. Baker PD, Westenskow DR, Kuck K. Theoretical analysis of non-invasive oscillometric maximum amplitude algorithm for estimating mean blood pressure. Med Biol Eng Comput. 1997;35:271-278. PUBMED 3. Ramsey M III. Blood pressure monitoring: automated oscillometric devices. J Clin Monit. 1991;7:56-67. FULL TEXT | ISI | PUBMED

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:2793.

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