Negishi, K and Yang, H and Wang, Y and Nolan, MT and Negishi, T and Pathan, F and Marwick, TH and Sharman, JE, Importance of calibration method in central blood pressure for cardiac structural abnormalities, American Journal of Hypertension, 29, (9) pp. 1070-1076. ISSN 0895-7061 (2016) [Refereed Article]
Copyright 2016 American Journal of Hypertension, Ltd.
Methods: A total of 349 community-based patients with risk factors (71±5years, 161 males) had CSBP measured by brachial oscillometry (Mobil-O-Graph, IEM GmbH, Stolberg, Germany) using 2 calibration methods: MAP-CSBP and Stan-CSBP. Left ventricular hypertrophy (LVH) and left atrial dilatation (LAD) were measured based on standard guidelines.
Results: MAP-CSBP was higher than Stan-CSBP (149±20 vs. 128±15mm Hg, P < 0.0001). Although they were modestly correlated (rho = 0.74, P < 0.001), the Bland-Altman plot demonstrated a large bias (21mm Hg) and limits of agreement (24mm Hg). In receiver operating characteristic (ROC) curve analyses, MAP-CSBP significantly better discriminated LVH compared with Stan-CSBP (area under the curve (AUC) 0.66 vs. 0.59, P = 0.0063) and brachial SBP (0.62, P = 0.027). Continuous net reclassification improvement (NRI) (P < 0.001) and integrated discrimination improvement (IDI) (P < 0.001) corroborated superior discrimination of LVH by MAP-CSBP. Similarly, MAP-CSBP better distinguished LAD than Stan-CSBP (AUC 0.63 vs. 0.56, P = 0.005) and conventional brachial SBP (0.58, P = 0.006), whereas Stan-CSBP provided no better discrimination than conventional brachial BP (P = 0.09).
Conclusions: CSBP is calibration dependent and when oscillometric MAP and DBP are used, the derived CSBP is a better discriminator for cardiac structural abnormalities.
|Item Type:||Refereed Article|
|Keywords:||blood pressure determinations, blood vessels, cardiovascular diagnostic technique, heart function tests, hypertension, pulse wave analysis|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|Author:||Negishi, K (Dr Kazuaki Negishi)|
|Author:||Yang, H (Ms Hong Yang)|
|Author:||Wang, Y (Ms Ying Wang)|
|Author:||Nolan, MT (Mr Mark Nolan)|
|Author:||Negishi, T (Dr Tomoko Negishi)|
|Author:||Pathan, F (Dr Faraz Pathan)|
|Author:||Marwick, TH (Professor Tom Marwick)|
|Author:||Sharman, JE (Professor James Sharman)|
|Web of Science® Times Cited:||9|
|Deposited By:||Menzies Institute for Medical Research|
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