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Development of an accurate oscillometric blood pressure device for low resource settings

de Greeff, Annemarie; Nathan, Hannah; Stafford, Nina; Liu, Bing; Shennan, Andrew H.

doi: 10.1097/MBP.0b013e32830fd07c
Original Articles

Objective To assess and develop an accurate blood pressure measurement device for use in low resource settings and by untrained staff, according to the World Health Organisation guidelines.

Methods Ninety-nine adults were recruited to validate the device according to the International Protocol of the European Society of Hypertension. All participants provided written informed consent. Patients with an arrhythmia or unclear Korotkoff sounds were excluded. Nine sequential same-arm measurements were taken from each participant alternating between the test device and mercury sphygmomanometry. Differences between the test device and observers were evaluated according to the criteria of the International Protocol and the Association for the Advancement of Medical Instrumentation.

Results The device failed the first assessment of the oscillometric function and required modification to both the deflation rate and the algorithm to fulfil the International Protocol criteria. It then achieved an acceptable mean difference of −0.7 (4.7) mmHg for systolic and −2.0 (4.6) mmHg for diastolic pressure (oscillometric function) and −1.9 (3.8) mmHg and −0.9 (3.3) mmHg for systolic and diastolic pressures, respectively (auscultatory function).

Conclusion The Microlife 3AS1-2 is a semi-automated upper arm device with features consistent with low resource requirements. We successfully developed this device for accurate blood pressure measurement in adults according to the International Protocol, through adjustment of the deflation rate and algorithm. The accuracy and user-friendly design of this low-cost device makes it a highly valuable monitor in clinical practice, particularly in low resource settings and for use by untrained staff.

Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College London, St Thomas' Hospital, London, UK

Correspondence to Professor Andrew Shennan, Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK

Tel: +44 20 7188 3639; fax: +44 20 7620 1227;


Previous presentations: part of the data has been presented as a poster at the European Society of Hypertension Conference in Milan in 2007.

Received 10 April 2008 Revised 23 June 2008 Accepted 24 June 2008

© 2008 Lippincott Williams & Wilkins, Inc.