Measurement of the ankle brachial index with a non-mercury sphygmomanometer in diabetic patients: a concordance study

BMC Cardiovascular Disorders

Pere Torán⁶  María Teresa Alzamora⁵  Rosa Forés⁵  Judit Lluss๠ Carmen Pérez²  Laura Muñoz-Ortíz³  Magali Urrea³  Magdalena Bundó⁴ 

[1] Primary Health Care Centre Sant Roc, Catalan Health Institute, C/ Velez Rubio s/n, Badalona, 08918, Spain;Primary Health Care Centre Llefià, Catalan Health Institute, Carretera Antigua de Valencia s/n, Badalona, Spain;Primary Health Care Research Support Unit Metropolitana Nord, IDIAP Jordi Gol, Catalan Health Institute, Carrer Major 49-53 (1st floor), Santa Coloma de Gramanet, 08921, Spain;Primary Health Care Centre Ronda Prim, Catalan Health Institute, Camí del Mig 36, (4th floor), Mataró, Barcelona, 08330, Spain;Primary Health Care Centre Riu Nord-Riu Sud, Catalan Health Institute, c/ Major 49 Sta. Coloma de Gramenet, Barcelona, 08921, Spain;Primary Health Care Centre Gatassa , Catalan Health Institute, Camí del Mig 36 (3rd floor), Mataró, 08303, Spain

关键词: Sensitivity and specificity;    Doppler;    Type 2 diabetes mellitus;    Blood pressure;    Peripheral arterial disease;    Ankle brachial blood pressure index;   

Others  :  857825
DOI  :  10.1186/1471-2261-13-15

 received in 2012-07-24, accepted in 2013-02-19,  发布年份 2013

【 摘 要 】

Background

The removal of mercury sphygmomanometers from health centers requires the validation of other instruments to measure blood pressure in the limbs to calculate the ankle-brachial index (ABI).

Methods

Descriptive cross-sectional study of agreement between two measurement methods in type 2 diabetes patients from three urban primary healthcare centres in the Barcelonès Nord i Maresme area (Catalonia, Spain).

ABI was determined with Doppler and mercury sphygmomanometer and Doppler and the “hybrid” sphygmomanometer OMRON HEM-907 model. Agreement was evaluated using the weighted kappa index. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using the mercury sphygmomanometer as the gold standard.

Results

211 patients were included, from these, 421 limbs were available for study. The mean age of the participants was 67 years (SD = 10), 51.7% were women.

The index of agreement between ABI measured with a mercury sphygmomanometer and with the OMRON HEM-907 blood pressure monitor was good (weighted kappa index = 0.68; CI 95%: [0.55–0.79]) and improved when the ABI cut-off value was set at ≤0.70 (weighted kappa index = 0.92; CI 95%: [0.81–1.00]). Sensitivity and specificity were 77.5% and 98.2%, respectively. PPV was 83.8% and NPV was 97.3%. With the ABI cut-off value ≤0.70, sensitivity and specificity increased to 85.7% and 100%, respectively, PPV to 100% and NPV to 99.4%.

Conclusion

The combination of a Doppler device with the hybrid sphygmomanometer is a simple and reliable method to measure ABI showing that hybrid sphygmomanometer is a good alternative to the use of mercury sphygmomanometers.

【 授权许可】

   
2013 Bundó et al.; licensee BioMed Central Ltd.

【 图 表 】

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