Clinical Utility of Blood Pressure Measurement Using the Newer Palpatory Method for Both Systolic and Diastolic Blood Pressure

Document Type : Original Article


1 MBBS IInd Year Student, AIIMS, Bhopal, Madhya Pradesh, India

2 Department of Physiology, AIIMS, Bhopal, Madhya Pradesh, India

3 Department of Oral Medicine and Radiology, Rishiraj College of Dental Sciences, Bhopal, Madhya Pradesh, India


Background: Blood pressure (BP) measurement being a part of clinical examination gives a fair idea about the hemodynamic status. The auscultatory method is considered as a gold standard, a simple, noninvasive way to measure BP in patients as well as in the healthy controls. The present study was designed to compare systolic BP (SBP) and diastolic BP (DBP) readings using a newer palpatory method with the standard auscultatory method and further assessing the reliability of the newer palpatory method. Materials and Methods: A cross-sectional study comprising of a total of 400 (240 males and 160 females) individuals in the age range of 20–60 years were included in this study. BP measurement was done by the standard auscultatory method by one observer. Another observer blinded with BP records of the auscultatory method, measured BP using the newer palpatory method on the same individuals. The two methods were compared for the inter-rater reliability using intraclass correlation (ICC) statistics and agreement between two methods using Bland–Altman analysis. Results: The present study observed excellent reliability of the newer palpatory method with the standard auscultatory method with an ICC value of 0.997 and 0.993 for SBP and DBP, respectively. Bland–Altman plot for both SBP and DBP using the auscultatory and newer palpatory method has shown minimum variability and good reliability when both methods are used by independent observers. Conclusions: With practice and experience newer palpatory method can be used to assess BP with accuracy.


Georgia A. The History of Sphygmomanometers. Available from:  Back to cited text no. 1
Senviro G. Why is mercury used in measuring blood pressure? eNotes 2015. Available from: [Last accessed on 2019 Jan 16].  Back to cited text no. 2
Marey EJ. Pressionetvitesse du sang. Physiologie Experimentale. Paris: Facsimile Publisher; 1876.  Back to cited text no. 3
Ogedegbe G, Pickering T. Principles and techniques of blood pressure measurement. Cardiol Clin 2010;28:571-86.  Back to cited text no. 4
Directive 2007/51/EC of the European Parliament and of the Council of 25 September 2007 amending Council Directive 76/769/EEC Relating to Restrictions on the Marketing of Certain Measuring Devices Containing Mercury (Text with EEA Relevance); 2007. Available from: 32007L0051. [Last accessed on 2015 Oct 30].  Back to cited text no. 5
Shahbabu B, Dasgupta A, Sarkar K, Sahoo SK. Which is more accurate in measuring the blood pressure? A digital or an aneroid sphygmomanometer. J Clin Diagn Res 2016;10:LC11-4.  Back to cited text no. 6
Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves JW, Hill MN, et al. Recommendations for blood pressure measurement in humans: An AHA scientific statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee. J Clin Hypertens (Greenwich) 2005;7:102-9.  Back to cited text no. 7
Bonnafoux P. Auscultatory and oscillometric methods of ambulatory blood pressure monitoring, advantages and limits: A technical point of view. Blood Press Monit 1996;1:181-5.  Back to cited text no. 8
Sahu D, Bhaskaran M. Palpatory method of measuring diastolic blood pressure. J Anaesthesiol Clin Pharmacol 2010;26:528-30.  Back to cited text no. 9
[PUBMED]  [Full text]  
Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, et al. Human blood pressure determination by sphygmomanometry. Circulation 1993;88:2460-70.  Back to cited text no. 10
Constant J. Arterial pulses and pressures. In: Essential of Bed Side Cardiology. 2nd ed.. New Jersy: Humana Press Inc; 2003. p. 29-46.  Back to cited text no. 11
Cavallini MC, Roman MJ, Blank SG, Pini R, Pickering TG, Devereux RB. Association of the auscultatory gap with vascular disease in hypertensive patients. Ann Intern Med 1996;124:877-83.  Back to cited text no. 12
Frech TM, Penrod J, Battistone MJ, Sawitzke AD, Stults BM. The prevalence and clinical correlates of an auscultatory gap in systemic sclerosis patients. Int J Rheumatol 2012;2012:590845.  Back to cited text no. 13
Mudd SG, White PD. The auscultatory gap in sphygmomanometry. Arch Intern Med (Chic) 1928;41:249-56.  Back to cited text no. 14
Askey JM. The auscultatory gap in sphygmomanometry. Ann Intern Med 1974;80:94-7.  Back to cited text no. 15
Sadawarte P, Bhure A, Chauhan S, Gawande R. Measurement of diastolic blood pressure without stethoscope... Is it possible? Sch J App Med Sci 2017;5:662-7.  Back to cited text no. 16