Tan, BV and Picone, DS and Schultz, MG and Armstrong, MK and Peng, X and Black, JA and Dwyer, N and Roberts-Thomson, P and Adams, H and Hughes, AD and Sharman, JE, Comparison between cuff-based and invasive systolic blood pressure amplification, Journal of Hypertension, 40, (10) pp. 2037-2044. ISSN 0263-6352 (2022) [Refereed Article]
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Official URL: https://journals.lww.com/jhypertension/Fulltext/20...
Objective:Accurate measurement of central blood pressure (BP) using upper arm cuff-based methods is associated with several factors, including determining the level of systolic BP (SBP) amplification. This study aimed to determine the agreement between cuff-based and invasively measured SBP amplification.
Methods:Patients undergoing coronary angiography had invasive SBP amplification (brachial SBP - central SBP) measured simultaneously with cuff-based SBP amplification using a commercially available central BP device (device 1: Sphygmocor Xcel; n = 171, 70% men, 60 +- 10 years) and a now superseded model of a central BP device (device 2: Uscom BP+; n = 52, 83% men, 62 +- 10 years).
Results:Mean difference (+-2SD, limits of agreement) between cuff-based and invasive SBP amplification was 4 mmHg (-12, +20 mmHg, P < 0.001) for device 1 and -2 mmHg (-14, +10 mmHg, P = 0.10) for device 2. Both devices systematically overestimated SBP amplification at lower levels and underestimated at higher levels of invasive SBP amplification, but with stronger bias for device 1 (r = -0.68 vs. r = -0.52; Z = 2.72; P = 0.008). Concordance of cuff-based and invasive SBP amplification across quartiles of invasive SBP amplification was low, particularly in the lowest and highest quartiles. The root mean square errors from regression between cuff-based central SBP and brachial SBP were significantly lower (indicating less variability) than from invasive regression models (P < 0.001).
Conclusions:Irrespective of the difference from invasive measurements, cuff-based estimates of SBP amplification showed evidence of proportional systematic bias and had less individual variability. These observations could provide insights on how to improve the performance of cuff-based central BP.
|Item Type:||Refereed Article|
|Keywords:||blood pressure;hypertension; public health;education; accuracy of blood pressure measurement|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Diagnosis of human diseases and conditions|
|UTAS Author:||Tan, BV (Dr Tan Bui)|
|UTAS Author:||Picone, DS (Dr Dean Picone)|
|UTAS Author:||Schultz, MG (Dr Martin Schultz)|
|UTAS Author:||Black, JA (Professor John Black)|
|UTAS Author:||Dwyer, N (Dr Nathan Dwyer)|
|UTAS Author:||Roberts-Thomson, P (Dr Philip Roberts-Thomson)|
|UTAS Author:||Adams, H (Dr Heath Adams)|
|UTAS Author:||Sharman, JE (Professor James Sharman)|
|Deposited By:||Menzies Institute for Medical Research|
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