Newly Published
Correspondence  |   January 2020
Ambulatory and Perioperative Blood Pressure: Comment
Author Notes
  • Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel. alex@avidan.co.il
  • Accepted for publication July 9, 2019.
    Accepted for publication July 9, 2019.×
Article Information
Correspondence
Correspondence   |   January 2020
Ambulatory and Perioperative Blood Pressure: Comment
Anesthesiology Newly Published on January 6, 2020. doi:https://doi.org/10.1097/ALN.0000000000003107
Anesthesiology Newly Published on January 6, 2020. doi:https://doi.org/10.1097/ALN.0000000000003107
We read with great interest the paper by Saugel et al.1  reporting that preinduction and lowest intraoperative blood pressure measurements are different than ambulatory measurements made during the daytime and nighttime.
Without entering the debate as to whether intraoperative blood pressure measurements can be used as surrogates for organ perfusion,2  and the fact that there is only an association and not direct causation between intraoperative mean arterial pressures lower than 65 mmHg and adverse clinical outcomes,3  we would like to address some methodologic issues concerning this study.
The two blood pressure monitors used in the study were not calibrated. It is possible that in the same individual there would be differences between simultaneous blood pressure measurements done with the two devices. Additionally, in the ambulatory setting, the blood pressure was measured on the nondominant arm. There is no information on whether this was also done in the operating room. This is an important issue as in many people there are differences in blood pressure measurements between the two arms.4  Moreover, in obese patients (who were not excluded), noninvasive blood pressure measurements are highly inaccurate when compared with invasive measurements.5