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American Journal of Epidemiology Advance Access originally published online on May 4, 2006
American Journal of Epidemiology 2006 164(1):85-94; doi:10.1093/aje/kwj160
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Practice of Epidemiology

Algorithms for Converting Random-Zero to Automated Oscillometric Blood Pressure Values, and Vice Versa

Andreas Stang1, Susanne Moebus2, Stefan Möhlenkamp3, Nico Dragano4, Axel Schmermund5, Eva-Maria Beck2, Johannes Siegrist4, Raimund Erbel3, Karl-Heinz Jöckel2 on behalf of the Heinz Nixdorf Recall Study Investigative Group

1 Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, University of Halle-Wittenberg, Halle, Germany
2 Institute of Medical Informatics, Biometry and Epidemiology, University Hospital, University of Duisburg-Essen, Essen, Germany
3 West German Heart Center, University Hospital, University of Duisburg-Essen, Essen, Germany
4 Institute of Medical Sociology, University of Duesseldorf, Duesseldorf, Germany
5 Cardioangiologisches Centrum, Bethanien, Frankfurt, Germany

Correspondence to Dr. Andreas Stang, Clinical Epidemiology Section, Institute of Medical Epidemiology, Biometry and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 27, 06110 Halle (Saale), Germany (e-mail: andreas.stang{at}medizin.uni-halle.de).

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.

blood pressure determination; cohort studies; epidemiologic methods; Germany; hypertension

Abbreviations: AOD, automated oscillometric blood pressure device; DBP, diastolic blood pressure; RZS, random-zero sphygmomanometer blood pressure device; SBP, systolic blood pressure


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