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Respiratory modulation of oscillometric cuff pressure pulses and Korotkoff sounds during clinical blood pressure measurement in healthy adults

Lookup NU author(s): Emeritus Professor Alan MurrayORCiD, Dr Ding Chang Zheng



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Accurate blood pressure (BP) measurement depends on the reliability of oscillometric cuff pressure pulses (OscP) and Korotkoff sounds (KorS) for automated oscillometric and manual techniques. It has been widely accepted that respiration is one of the main factors affecting BP measurement. However, little is known about how respiration affects the signals from which BP measurement is obtained. The aim was to quantify the modulation effect of respiration on oscillometric pulses and KorS during clinical BP measurement.Methods: Systolic and diastolic BPs were measured manually from 40 healthy subjects (from 23 to 65 years old) under normal and regular deep breathing. The following signals were digitally recorded during linear cuff deflation: chest motion from a magnetometer to obtain reference respiration, cuff pressure from an electronic pressure sensor to derive OscP, and KorS from a digital stethoscope. The effects of respiration on both OscP and KorS were determined from changes in their amplitude associated with respiration between systole and diastole. These changes were normalized to the mean signal amplitude of OscP and KorS to derive the respiratory modulation depth. Reference respiration frequency, and the frequencies derived from the amplitude modulation of OscP and KorS were also calculated and compared.Results: Respiratory modulation depth was 14 and 40 % for OscP and KorS respectively under normal breathing condition, with significant increases (both p < 0.05) to 16 and 49 % with deeper breathing. There was no statistically significant difference between the reference respiration frequency and those derived from the oscillometric and Korotkoff signals (both p > 0.05) during deep breathing, and for the oscillometric signal during normal breathing (p > 0.05).Conclusions: Our study confirmed and quantified the respiratory modulation effect on the oscillometric pulses and KorS during clinical BP measurement, with increased modulation depth under regular deeper breathing.

Publication metadata

Author(s): Chen DL, Chen F, Murray A, Zheng DC

Publication type: Article

Publication status: Published

Journal: BioMedical Engineering Online

Year: 2016

Volume: 15

Online publication date: 10/05/2016

Acceptance date: 05/05/2016

Date deposited: 06/06/2016

ISSN (electronic): 1475-925X

Publisher: BioMed Central Ltd


DOI: 10.1186/s12938-016-0169-y


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Funder referenceFunder name
61571213National Natural Science Foundation of China
EP/I027270/1Engineering and Physical Sciences Research Council (EPSRC)