Sources of automatic office blood pressure measurement error: a systematic review

Jian Liu, Yumin Li, Jianqing Li, Dingchang Zheng, Chengyu Liu

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    Objective: Accurate and reliable blood pressure (BP) measurement is important for the prevention and treatment of hypertension. The oscillometric-based automatic office blood pressure measurement (AOBPM) is widely used in hospitals and clinics, but measurement errors are common in BP measurements. There is a lack of systematic review of the sources of measurement errors. Approach: A systematic review of all existing research on sources of AOBPM errors. A search strategy was designed in six online databases, and all the literature published before October 2021 was selected. Those studies that used the AOBPM device to measure BP from the upper arm of subjects were included. Main results: A total of 1365 studies were screened, and 224 studies were included in this final review. They investigated 22 common error sources with clinical AOBPM. Regarding the causes of BP errors, this review divided them into the following categories: the activities before measurement, patient’s factors, measurement environment, measurement procedure, and device settings. 13 sources caused increased systolic and diastolic BP (SBP and DBP), 2 sources caused the decrease in SBP and DBP, only 1 source had no significant effect on BPs, and the other errors had a non-uniform effect (either increase or decrease in BPs). The error ranges for SBP and DBP were −14 to 33 mmHg and −6 to 19 mmHg, respectively. Significance: The measurement accuracy of AOBPM is susceptible to the influence of measurement factors. Interpreting BP readings need to be treated with caution in clinical measurements. This review made comprehensive evidence for the need for standardized BP measurements and provided guidance for clinical practitioners when measuring BP with AOBPM devices.

    Original languageEnglish
    Article number 09TR02
    Number of pages22
    JournalPhysiological Measurement
    Issue number9
    Early online date5 Sept 2022
    Publication statusPublished - 30 Sept 2022

    Bibliographical note

    This is the Accepted Manuscript version of an article accepted for publication in Physiological Measurement. IOP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at

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    This document is the author’s post-print version, incorporating any revisions agreed during the peer-review process. Some differences between the published version and this version may remain and you are advised to consult the published version if you wish to cite from it.


    This research was funded by the National Key Research and Development Program of China (2019YFE0113800), the National Natural Science Foundation of China (62171123, 62071241 and 81871444) and the Natural Science Foundation of Jiangsu Province (BK20190014 and BK20192004)


    • Blood pressure (BP)
    • Sources of measurement error
    • Systolic and diastolic blood pressure (SBP and DBP)
    • Automatic office BP measurement (AOBPM)


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