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Are blood pressure monitors affected by high altitude?
  1. Willem J Verberk1,2,
  2. Stephan Mieke3
  1. 1Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
  2. 2Department of Research and Development, Microlife Corporation, Taipei, Taiwan
  3. 3Physikalisch-Technische Bundesanstalt, Berlin, Germany
  1. Correspondence to Dr Willem Verberk, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, PO Box 616 6200 MD, The Netherlands; willem.verberk{at}

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The importance of accurate blood pressure measurement cannot be overemphasised, and there is an overall understanding that validated blood pressure monitors are needed for reliable pressure measurement. However, some researchers have raised the question whether high altitude, mainly due to the lower atmospheric pressure, can affect the accuracy of automatic blood pressure monitors.1–3

In the current issue of the journal, Mingji et al present a systematic review about the accuracy of blood pressure measuring devices in the Tibetan areas of China.4 The authors conclude that oscillometric blood pressure monitors, which are validated at sea level, agree well with the mercury sphygmomanometer for diastolic blood pressure measured at high altitudes, but the degree of such accuracy for systolic blood pressure is not consistent.

However, the two studies that were included in the review and led to this conclusion show some significant differences in both material and methods between its performance at sea level and high altitude. Therefore, it should be questioned whether the obtained blood pressure differences can be ascribed to high altitude.

In most blood pressure measurement studies performed at high altitude, researchers question the accuracy of oscillometric devices but assume that the mercury sphygmomanometer is not affected by high altitude. However, for a good understanding of the technical aspects of blood pressure measurement at high altitude, two questions should be answered first:

  1. Is it correct to assume that …

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