Algorithms for converting random-zero to automated oscillometric blood pressure values, and vice versa

Many surveys and cohort studies have used a random-zero sphygmomanometer blood pressure device (RZS) to measure subjects' blood pressure and to assess the value of blood pressure in predicting cardiovascular events. Recent studies used automated oscillometric blood pressure devices (AODs) that systematically measure higher blood pressure values than RZSs do, hampering comparability of values between these studies. In 2000-2003, the authors randomly used both an RZS and an AOD in an ongoing cohort study in Germany. This analysis aimed to compare blood pressure values by device and to develop an algorithm to convert estimates of blood pressure values from one device to the other. In a randomized subset of 2,365 subjects aged 45-75 years, each subject was measured three times with each device in a randomized order. The mean difference (AOD-RZS) between the devices was 3.9 mmHg for systolic blood pressure and 2.6 mmHg for diastolic blood pressure. The authors found that linear regression models including age, sex, and blood pressure level can be used to convert RZS blood pressure values to AOD blood pressure values, and vice versa. Results may help to better compare blood pressure values in epidemiologic studies that used different blood pressure devices.