Comparative accuracy of two new electronic devices for the noninvasive determination of blood pressure

Recent developments in behavioral approaches to cardiovascular disease have called for physiological monitoring devices that reduce experimenter bias, are easy to operate, can be used ambulatorily, and/or provide ongoing, automated monitoring of pertinent cardiovascular functions--i.e., blood pressure and heart rate. Neither the invasive monitoring (via catheterization) nor the standard auscultatory method of blood pressure determination, however, has these characteristics. In the present study, two new methods/devices--(1) a low-weight, low-cost, battery-operated sphygmomanometer (SM), and (2) a more expensive automated electronic SM with electrical pump-are compared with each other and with the more common auscultatory method and a standard mercury SM. Both new devices were also compared with a standard pulse count. Data were derived from 10 readings of 10 healthy subjects each across the three possible comparisons, thus totaling N = 30. Correlation coefficients and average differences were computed and indicated high intercorrelations (between r = .89 and r = .99) between each pairing of the new electronic devices and the mercury SM. Intercorrelations of blood pressure determination with the two new electronic devices, however, were only moderate. Potential reasons for the variability are discussed, and guidelines for the optimal use of the new, easy-to-operate electronic devices are presented.     

基于柯氏音识别法的自动血压测量系统

市场上的电子血压计一般均采用示波法,采用间接测量原理,其准确性难以提高。柯氏音法是血压测量的金标准,有望提高自动血压测量准确性,但柯氏音的降噪和识别是难题。因此,提出了基于柯氏音识别法的自动血压测量系统,该系统解决了降噪和识别的难题,通过对实时柯氏音信号的测试表明该系统可以有效地识别出柯氏音,得出收缩压和舒张压,识别精度高。且该系统成本低廉,测试实验均造作于Android系统的手机上,易于实现社区血压的健康管理和远程监控。     

Comparison of performance of various sphygmomanometers with intra-arterial blood-pressure readings.

Seven types of sphygmomanometer were used in random order on each of nine hypertensive patients and the readings compared with simultaneous intra-arterial blood-pressure recordings. All the devices gave significantly different values for systolic pressure, and only two measured diastolic pressure without significant error. Systolic pressure was consistently underestimated (range 31-7 mm Hg), and all but one instrument overestimated diastolic pressure (range 10-2 mm Hg). The variability of readings was least with the standard mercury sphygmomanometer and the random-zero machine, while with some of the more automated devices single readings were in error up to -68/33 mm Hg. The strong correlations found between intra-arterial and cuff systolic pressures with all devices tested and significant correlations for diastolic pressure with all but one device indicate that, with one possible exception, the sphygmomanometers would give accurate results where a change in blood pressure was the main concern.     

Noninvasive, automatic 24-h ambulatory blood pressure monitoring in normotensive subjects

The reliability of noninvasive, automatic blood pressure monitoring is not yet clearly established. A 24-h ambulatory blood pressure profile was obtained in 9 healthy, normotensive subjects with an automatic, noninvasive device. The blood pressure profile showed the typical circadian pattern with lower systolic and diastolic values during sleep, although pulse pressure was fairly constant (about 40 mm Hg). The systolic blood pressure rose steeply in the early morning hours--before waking up. The results were compared with simultaneous hourly readings using the auscultatory method. There were no statistically significant differences between the automatic and auscultatory readings, 13 of the 18 mean values at different time points being within 2 mm Hg of each other. All the auscultatory means fell within the 95% confidence limits of those measured hourly by the automatic method. Although the automatic method seemed to be reliable compared with the auscultatory method, its sensitivity to motion artifacts is a disadvantage in a truly ambulatory setting.     

Cytogenetic monitoring of fishermen with environmental mercury exposure

Due to high mercury levels in many Mediterranean aquatic organisms, people who live in this area and consume large amounts of seafood are exposed to a toxicological hazard. A group of 51 fishermen exposed to mercury through eating contaminated seafood from the northern Tyrrhenian Sea underwent cytogenetic monitoring. This work is part of a research project consisting of the evaluation of micronuclei (MN), chromosomal aberrations (CA) and sister-chromatid exchanges (SCE) in peripheral blood lymphocytes. Here we present data on mercury levels in blood and on micronucleus frequencies in peripheral blood lymphocytes of fishermen. The range of mercury concentrations in blood was 10.08–304.11 ng/g fresh weight, the average was 88.97±54.09 ng/g. Micronucleus frequency was defined with at least 2000 binucleated cells scored for each person; the average was 8.74 ± 2.56 expressed on 1000 binucleated cells. A statistical correlation was found between MN frequency and total mercury concentration in blood (p = 0.00041, r = 0.674), as well as between MN frequency and age (p = 0.017). No other parameters taken into account correlated with MN frequency.     

Evaluation of the characteristics and performance of an automatic sphygmomanometer (Omega 1400)

24 hour pressure monitoring is a newly developing technique potentially yielding important informations in hypertensive patients. Numerous automated devices are available whose performance characteristics are poorly documented. To evaluate an automated sphygmomanometer commonly used in our Division (Omega 1400, Invivo Research Laboratories), we performed a series of measurements, simultaneously recording blood pressure in the opposite arm with a common sphygmomanometer. Each measure was then repeated reversing the position of the two devices (manual and automated), thus abolishing possible differences between the two arms. We observed a mean underestimation of 1.90 mmHg of systolic pressure and of 4.82 mmHg of diastolic blood pressure by the automated device. We conclude that the device by us evaluated is not advisable in the basal blood pressure evaluation, but useful in monitoring inpatients.     

Differential pulse amperometric detection of drugs in plasma using a dropping mercury electrode as a high-performance liquid chromatographic detector

High-performance liquid chromatographic separation prior to reductive electrochemical determination at the dropping mercury electrode imparts specificity and sensitivity not attainable by conventional polarographic analysis of drugs and their metabolites. The utility of this novel approach is demonstrated by the analysis of chlordiazepoxide and its N-desmethyl metabolite in plasma which previously required thin-layer chromatographic separation prior to polarographic measurement. A mobile phase of methanol—isopropanol—0.0075 M acetate buffer, pH 3.5 (53:5:42), is used with the detector operated in the differential pulse mode at E_p = ?0.820 V vs. Ag/AgCl. The response was linear (r = 0.998) in the concentration range of 0.05–2.0 μg/ml plasma for each component. The minimum detectability for each component under these conditions is 5.0 ng injected at a current range of 0.5 μA full scale. Techniques for oxygen removal and hydrodynamic considerations for the pumping system are presented.     

Effect of selenium on determination of mercury in animal tissues.

Selenium in animal tissues was found to influence the reactivity of mercury in the tissues with stannous chloride or with stannous chloride plus cadmium chloride added as reducing agents for the determination of mercury by the method developed by L. Magos (1971, Analyst, 96, 847–853) and L. Magos and T. W. Clarkson (1972, J. Assoc. Offic. Anal. Chem., 55, 966–971). The recovery of mercury in the tissues of animals to which inorganic mercury and selenite were simultaneously administered was low compared to the case in which inorganic mercury alone was administered. Of the in vitro interactions of inorganic mercury and selenite examined in tissue homogenates and blood samples, only those interactions in blood samples caused the difficulty in mercury analysis mentioned above, i.e., there was a marked decrease in recovery of mercury when an equimolar amount of each compound was added to the blood. These facts suggest that selenium and inorganic mercury in the animal tissues are likely to interact with each other and might form a chemically stable state of inorganic mercury which resists reduction with stannous chloride in the procedure for mercury determination.     

Characterization of a novel microfluidic platform for the isolation of rare single cells to enable CTC analysis from head and neck squamous cell carcinoma patients

Detailed examination of tumor components is leading‐edge to establish personalized cancer therapy. Accompanying research on cell‐free DNA, the cell count of circulating tumor cells (CTCs) in patient blood is seen as a crucial prognostic factor. The potential of CTC analysis is further not limited to the determination of the overall survival rate but sheds light on understanding inter‐ and intratumoral heterogeneity. In this regard, commercial CTC isolation devices combining an efficient enrichment of rare cells with a droplet deposition of single cells for downstream analysis are highly appreciated. The Liquid biopsy platform CTCelect was developed to realize a fully‐automated enrichment and single cell dispensing of CTCs from whole blood without pre‐processing. We characterized each process step with two different carcinoma cell lines demonstrating up to 87 % enrichment (n = 10) with EpCAM coupled immunomagnetic beads, 73 % optical detection and dispensing efficiency (n = 5). 40 to 56.7 % of cells were recovered after complete isolation from 7.5 ml untreated whole blood (n = 6). In this study, CTCelect enabled automated dispensing of single circulating tumor cells from HNSCC patient samples, qPCR‐based confirmation of tumor‐related biomarkers and immunostaining. Finally, the platform was compared to commercial CTC isolation technologies to highlight advantages and limitations of CTCelect. This system offers new possibilities for single cell screening in cancer diagnostics, individual therapy approaches and real‐time monitoring.     

Observer error in blood pressure measurement.

This paper describes an experiment undertaken to determine observer error in measuring blood pressure by the auscultatory method. A microcomputer was used to display a simulated mercury manometer and play back tape-recorded Korotkoff sounds synchronized with the fall of the mercury column. Each observer''s readings were entered into the computer, which displayed a histogram of all readings taken up to that point and thus showed the variation among observers. The procedure, which could easily be adapted for use in teaching, was used to test 311 observers drawn from physicians, nurses, medical students, nursing students and others at nine health care institutions in Ottawa. The results showed a strong bias for even-digit readings and standard deviations of roughly 5 to 6 mm Hg. The standard deviation for the systolic readings was somewhat smaller for the physicians as a group than for the nurses (3.5 v. 5.9 mm Hg). However, the standard deviations for the diastolic readings were roughly equal for these two groups (approximately 5.5 mm Hg).     

Evaluation of a community-based automated blood pressure measuring device

Background

Automated devices are widely available in the community for people to measure their blood pressure. We assessed the accuracy and reproducibility of a brand of community-based automated device against the standard mercury sphygmomanometer.

Methods

Same-arm pairs of blood pressure readings were obtained with the Vita-Stat 90550 automated device, a sphygmomanometer and the Omron HEM-705CP automated device in random order on volunteers in 3 community pharmacies using a modified protocol for evaluating blood pressure devices. Comparison of readings between the Omron device and the sphygmomanometer served as a positive control of how well a laboratory-validated automated device could perform in the community. Both the Association for the Advancement of Medical Instrumentation (AAMI) and British Hypertension Society (BHS) criteria were used to assess the accuracy and reproducibility of readings.

Results

The mean blood pressure reading and standard error (SE) of the mean for the 108 volunteers (66 women and 42 men) was 133/77 (SE 2/1) mm Hg with the Vita-Stat device, 131/77 (SE 2/1) mm Hg with the Omron device and 129/76 (SE 2/1) mm Hg with the sphygmomanometer. The mean difference in readings was 4.4/1.0 (standard deviation [SD] 9.4/6.2) mm Hg between the Vita-Stat device and the sphygmomanometer and 1.6/0.6 (SD 9.3/6.4) mm Hg between the Omron device and the sphygmomanometer. Neither automated device met the AAMI accuracy criteria for the systolic readings. The BHS grades were C/A (systolic unacceptable/diastolic acceptable) for each automated device. According to the BHS analytical criterion, all devices achieved acceptable reproducibility grades.

Interpretation

Neither automated device met the AAMI or BHS criteria for accuracy while in use in the community, and neither performed as well in the community as in the laboratory.Measurement of blood pressure outside the office setting, using ambulatory monitors, home recorders or community-based devices has become popular among both physicians and patients. These devices may help to improve patients'' involvement in their care¹ and they may allay physicians'' concerns about a possible “white-coat syndrome.” However, incorrect readings could lead to a false sense of security or incorrect clinical decisions.The British Hypertension Society (BHS)² and the Association for the Advancement of Medical Instrumentation (AAMI)³ have developed laboratory protocols to evaluate automated blood pressure measuring devices. Many devices have failed to meet minimum standards for accuracy and reproducibility.⁴One community-based device, the Vita-Stat, has been available in various models since 1976, although none has performed uniformly well in community evaluations.^5,6,7,8,9 The newest model, the Vita-Stat 90550, available in about 3000 Canadian communities since 1990, provides 40 million readings yearly (Fred Sarkis, Spacelabs Medical: personal communication, 2000). Hence, we decided to evaluate the Vita-Stat 90550 against the mercury sphygmomanometer for accuracy and reproducibility in the community. To assess how well a laboratory-validated device could perform in the community, we compared the Omron HEM-705CP, which has met both the BHS and the AAMI criteria,¹⁰ against the mercury sphygmomanometer.     

Accuracy of auscultatory blood pressure measurement with a long cuff.

Intra-arterial blood pressure was compared with simultaneous auscultatory measurements in 37 subjects with a wide range of blood pressures and arm circumferences; six cuffs of various lengths and widths were used. Nineteen subjects had an arm circumference of 34 cm or more (mean 40 cm) and the other 18 were considered to be non-obese and had a mean arm circumference of 30 cm. With each larger cuff, in terms of bladder surface area, auscultatory blood pressure decreased a few mm relative to intra-arterial pressure both for systolic and for diastolic measurements. Apart from diastolic pressure measured with the two 12 cm wide cuffs (12 X 23 cm, 12 X 30 cm) in the obese group all other auscultatory measurements differed less than 5% from intra-arterial pressure, albeit with considerable variability among the subjects. The differences in error among measurements with the four largest cuffs in the obese group (13 X 30 cm, 14 X 30 cm, 14 X 38 cm, and a conical cuff) were clinically irrelevant, and there was even less to choose among all six cuffs in the non-obese subjects. These results suggest that auscultatory blood pressure may be measured with acceptable accuracy with a single long bladdered cuff both in subjects with large arms and in subjects with normal sized arms.     

Hypoglycemia assessed by continuous glucose monitoring is associated with preclinical atherosclerosis in individuals with impaired glucose tolerance

Hypoglycemia is associated with increased risk of cardiovascular adverse clinical outcomes. There is evidence that impaired glucose tolerance (IGT) is associated with cardiovascular morbidity and mortality. Whether IGT individuals have asymptomatic hypoglycemia under real-life conditions that are related to early atherosclerosis is unknown. To this aim, we measured episodes of hypoglycemia during continuous interstitial glucose monitoring (CGM) and evaluated their relationship with early manifestation of vascular atherosclerosis in glucose tolerant and intolerant individuals. An oral glucose tolerance test (OGTT) was performed in 79 non-diabetic subjects. Each individual underwent continuous glucose monitoring for 72 h. Cardiovascular risk factors and ultrasound measurement of carotid intima-media thickness (IMT) were evaluated. IGT individuals had a worse cardiovascular risk profile, including higher IMT, and spent significantly more time in hypoglycemia than glucose-tolerant individuals. IMT was significantly correlated with systolic (r = 0.22; P = 0.05) and diastolic blood pressure (r = 0.28; P = 0.01), total (r = 0.26; P = 0.02) and LDL cholesterol (r = 0.27; P = 0.01), 2-h glucose (r = 0.39; P<0.0001), insulin sensitivity (r = −0.26; P = 0.03), and minutes spent in hypoglycemia (r = 0.45; P<0.0001). In univariate analyses adjusted for gender, minutes spent in hypoglycemia were significantly correlated with age (r = 0.26; P = 0.01), waist circumference (r = 0.33; P = 0.003), 2-h glucose (r = 0.58; P<0.0001), and 2-h insulin (r = 0.27; P = 0.02). In a stepwise multivariate regression analysis, the variables significantly associated with IMT were minutes spent in hypoglycemia (r² = 0.252; P<0.0001), and ISI index (r² = 0.089; P = 0.004), accounting for 34.1% of the variation. Episodes of hypoglycemia may be considered as a new potential cardiovascular risk factor for IGT individuals.     

Hand-held lactate analyzer as a tool for the real-time measurement of physical fatigue before slaughter and pork quality prediction

The objectives of this study were to assess the relationship between blood lactate variation measured at the plant, and pork quality variation on a large sample size and under commercial preslaughter handling conditions. A total of 600 pigs were randomly chosen on arrival at a commercial slaughter plant and blood samples taken from the ear vein at unloading (UN), after lairage (LA), in the restrainer (RE; before stunning) and at exsanguination (EX) were analysed for lactate content using a Lactate Scout Analyzer (LSA). In order to have a large range of measures, pigs were distributed into two groups; one kept in lairage overnight (G1) and the other for 2 to 3 h (G2) before slaughter. Meat quality was assessed in the Longissimus thoracis (LT), Semimembranosus (SM) and Adductor (AD) muscles by measuring the pH 30 min postmortem (pH1) and at 24 h postmortem (pHu), the colour and the drip loss. Blood lactate levels did not differ between G1 and G2 (P>0.05). A reduced muscle lactate and glucose contents (P=0.02 and P=0.004, respectively) resulting in a lower (P<0.001) glycolytic potential (GP) was observed in the LT muscle of G1 pigs when compared with G2 loins. In the LT muscle of G1 pigs, the lower GP resulted in an increased pHu (r=−0.67; P<0.001), decreased drip loss (r=0.57; P<0.001) and darker colour (r=0.50; P<0.001) compared with G2. In both G1 and G2 pigs, the lower GP was correlated to higher pHu value in the SM and AD muscles (r=−0.73; P<0.001). The greatest correlation was observed in G2 between blood lactate levels at LA and pHu value of the SM and AD muscles (r=0.46 and r=0.44, respectively; P<0.001 for both muscles). The second greatest correlation was found between blood lactate levels at EX and pH1 value in the SM muscle in both groups (r=−0.37 and r=−0.41, respectively; P<0.001 for both groups). Based on the results of this study, it appears that blood lactate levels, as measured by the LSA, reliably reflect the physiological response of pigs to perimortem stress and may help explain the variation in pork quality.     

High-performance liquid chromatographic method for the direct determination of 4-methylumbelliferone and its glucuronide and sulfate conjugates: Application to studies in the single-pass in situ perfused rat intestine—liver preparation

A direct high-performance liquid chromatographic (HPLC) assay was developed for the separation and determination of 4-methylumbelliferone (4MU) and its glucuronide (MUG) and sulfate (MUS) conjugates in the cell-free perfusate (“plasma”) from in situ perfused rat intestine—liver preparation. In addition, a procedure was developed to extract and determine 4MU in the whole blood perfusate. Perfusate plasma containing an internal standard (umbelliferone) was precipitated with methanol (1:4, v/v), and injected into a reversed-phase HPLC system with gradient elution. 4MU and the same internal standard were also extracted directly from the whole blood perfusate with ethyl acetate and injected into a reversed-phase HPLC system with isocratic elution. Inter- and intra-day precision studies (n = 5 for each) for both the plasma and whole blood procedures demonstrated relative standard deviations of less than 10% at all concentrations studied. The compounds were stable in either the plasma or blood extracts at room temperature for up to 72 h. The procedures were successfully used to analyze perfusate samples obtained from the single-pass in situ perfusion of rat intestine—liver system with either trace (0.95 nM) or 32.3 μM concentrations of 4MU. The intestine was responsible for the formation of most of the MUG formed by the intestine—liver preparation during steady-state perfusion with either input concentration of 4MU.     

Circadian Time Structure of Cardiovascular Characteristics in Human Pregnancy

Conventional time-unspecified single measurements of blood pressure and heart rate may be misleading because they may be influenced, among other factors, by the patient's emotional state, position, diet, and external stimuli. All of these effects depend on the stages of a (mathematical) spectrum of rhythms and trends with age. The evaluation of predictable variability in blood pressure and heart rate by (a) the use of fully ambulatory devices, and (b) chronobiologic data processing, assesses early cardiovascular disease risk, e.g., in pregnancy. We have used this approach to quantify changes in 24-h synchronized (circadian) characteristics of cardiovascular variables in two consecutive pregnancies of a clinically healthy woman. Blood pressure and heart rate were automatically monitored, with few interruptions, at I-h intervals, each time for at least 48 consecutive h, and for a total of 76 days of monitoring in each pregnancy. Circadian parameters of those circulatory variables were computed for each single day of measurement by the least-squares fit of a 24-h cosine curve. Regression analysis of parameters thus obtained revealed patterns of variation of circadian-rhythm-adjusted means and amplitudes with gestational age. In both pregnancies, the predictable variability of the circadian-rhythm-adjusted mean of blood pressure can be approximated by a second-order polynomial model on gestational age: a steady linear decrease in systolic, diastolic, and mean arterial blood pressure up to the 22nd week of pregnancy is followed by an increase in blood pressure up to the day of delivery. This longitudinal study confirms and extends to ambulatory everyday life conditions the predictable pregnancy-associated variability in blood pressure and heart rate and also allows the establishment of prediction and confidence limits for cardiovascular parameters in a healthy pregnancy.     

Smooth muscle protein 22 alpha-Cre is expressed in myeloid cells in mice

Background: Experiments using Cre recombinase to study smooth muscle specific functions rely on strict specificity of Cre transgene expression. Therefore, accurate determination of Cre activity is critical to the interpretation of experiments using smooth muscle specific Cre. Methods and results: Two lines of smooth muscle protein 22 α-Cre (SM22α-Cre) mice were bred to floxed mice in order to define Cre transgene expression. Southern blotting demonstrated that SM22α-Cre was expressed not only in tissues abundant of smooth muscle, but also in spleen, which consists largely of immune cells including myeloid and lymphoid cells. PCR detected SM22α-Cre expression in peripheral blood and peritoneal macrophages. Analysis of SM22α-Cre mice crossed with a recombination detector GFP mouse revealed GFP expression, and hence recombination, in circulating neutrophils and monocytes by flow cytometry. Conclusions: SM22α-Cre mediates recombination not only in smooth muscle cells, but also in myeloid cells including neutrophils, monocytes, and macrophages. Given the known contributions of myeloid cells to cardiovascular phenotypes, caution should be taken when interpreting data using SM22α-Cre mice to investigate smooth muscle specific functions. Strategies such as bone marrow transplantation may be necessary when SM22α-Cre is used to differentiate the contribution of smooth muscle cells versus myeloid cells to observed phenotypes.     

Concurrent validity of the Microsoft Kinect for assessment of spatiotemporal gait variables

Spatiotemporal characteristics of gait such as step time and length are often associated with overall physical function in clinical populations, but can be difficult, time consuming and obtrusive to measure. This study assessed the concurrent validity of overground walking spatiotemporal data recorded using a criterion reference – a marker-based three-dimensional motion analysis (3DMA) system – and a low-cost, markerless alternative, the automated skeleton tracking output from the Microsoft Kinect™ (Kinect). Twenty-one healthy adults performed normal walking trials while being monitored using both systems. The outcome measures of gait speed, step length and time, stride length and time and peak foot swing velocity were derived using supervised automated analysis. To assess the agreement between the Kinect and 3DMA devices, Bland–Altman 95% bias and limits of agreement, percentage error, relative agreement (Pearson's correlation coefficients: r) overall agreement (concordance correlation coefficients: r_c) and landmark location linearity as a function of distance from the sensor were determined. Gait speed, step length and stride length from the two devices possessed excellent agreement (r and r_c values >0.90). Foot swing velocity possessed excellent relative (r=0.93) but only modest overall (r_c=0.54) agreement. Step time (r=0.82 and r_c=0.23) and stride time (r=0.69 and r_c=0.14) possessed excellent and modest relative agreement respectively but poor overall agreement. Landmark location linearity was excellent (R²=0.991). This widely available, low-cost and portable system could provide clinicians with significant advantages for assessing some spatiotemporal gait parameters. However, caution must be taken when choosing outcome variables as some commonly reported variables cannot be accurately measured.     

Finger systolic pressure: its use in screening for hypertension and monitoring.

A finger sphygmomanometer was compared with a mercury column sphygmomanometer for its ability to screen for hypertension. A total of 881 patients used each machine, both in initial screening and then for monitoring. The finger sphygmomanometer had a specificity of 98.5% in routine screening as compared with 97.6% for the mercury column device. Sensitivity of the finger device was 98.2%. These findings suggest that the finger sphygmomanometer using finger systolic pressure alone is adequate for screening and monitoring blood pressure.     

Noninvasive measurement of blood pressure in African green monkeys (Cercopithecus aethiops)

Indirect measurements of arterial blood pressure were made in African green monkeys (Cercopithecus aethiops) employing a Doppler ultrasound stethoscope and standard cuff and an Infrasonde automatic blood pressure recorder. Measurements were obtained from anesthetized (10 mg/kg ketamine (HCI) and unanesthetized (1.5 mg/kg ketamine HCI) animals. Ketamine had no significant effect on blood pressure. Indirect measurements from the brachial artery were compared with direct femoral artery measurements and with each other. Systolic blood pressures measured by the Doppler (r = .948) and Infrasonde (r = .920) methods correlated closely with direct measurements but were significantly lower than systolic blood pressures measured by the direct method. Diastolic blood pressures measured by the Infrasonde method agreed closely with direct measurements (r = .947). Systolic blood pressures measured by the indirect methods correlated closely in both anesthetized (r = .973) and unanesthetized (r = .834) animals and were not significantly different. Mean blood pressures calculated from direct and Infrasonde measurements also correlated closely (r = .963), with direct measurements being 4 mmHg higher on the average. Mean blood pressures are less influenced by methodology and are more reproducible than other pressures. These noninvasive methods can be used to obtain simple and accurate measurements of blood pressure from anesthetized and unanesthetized monkeys and are of value in long-term studies in monkeys.