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Identifying Isolated Systolic Hypertension from Upper-Arm Cuff Blood Pressure Compared with Invasive Measurements

Citation

Picone, DS and Schultz, MG and Armstrong, MK and Black, JA and Bos, WJW and Chen, CH and Cheng, HM and Cremer, A and Dwyer, N and Hughes, AD and Kim, HL and Lacy, PS and Laugesen, E and Liang, F and Ohte, N and Okada, S and Omboni, S and Ott, C and Pereira, T and Pucci, G and Schmieder, RE and Sinha, MD and Stouffer, GA and Takazawa, K and Roberts-Thomson, P and Wang, JG and Weber, T and Westerhof, BE and Williams, B and Sharman, JE, Identifying Isolated Systolic Hypertension from Upper-Arm Cuff Blood Pressure Compared with Invasive Measurements, Hypertension, 77, (2) pp. 632-639. ISSN 0194-911X (2021) [Refereed Article]

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DOI: doi:10.1161/HYPERTENSIONAHA.120.16109

Abstract

Isolated systolic hypertension (ISH) is the most common form of hypertension and is highly prevalent in older people. We recently showed differences between upper-arm cuff and invasive blood pressure (BP) become greater with increasing age, which could influence correct identification of ISH. This study sought to determine the difference between identification of ISH by cuff BP compared with invasive BP. Cuff BP and invasive aortic BP were measured in 1695 subjects (median 64 years, interquartile range [55-72], 68% male) from the INSPECT (Invasive Blood Pressure Consortium) database. Data were recorded during coronary angiography among 29 studies, using 21 different cuff BP devices. ISH was defined as ≥130/<80 mm Hg using cuff BP compared with invasive aortic BP as the reference. The prevalence of ISH was 24% (n=407) according to cuff BP but 38% (n=642) according to invasive aortic BP. There was fair agreement (Cohen κ, 0.36) and 72% concordance between cuff and invasive aortic BP for identifying ISH. Among the 28% of subjects (n=471) with misclassification of ISH status by cuff BP, 20% (n=96) of the difference was due to lower cuff systolic BP compared with invasive aortic systolic BP (mean, -16.4 mm Hg [95% CI, -18.7 to -14.1]), whereas 49% (n=231) was from higher cuff diastolic BP compared with invasive aortic diastolic BP (+14.2 mm Hg [95% CI, 11.5-16.9]). In conclusion, compared with invasive BP, cuff BP fails to identify ISH in a sizeable portion of older people and demonstrates the need to improve cuff BP measurements.

Item Details

Item Type:Refereed Article
Keywords:catheterization, pulse wave analysis, blood pressure measurement/monitoring, artery
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Picone, DS (Dr Dean Picone)
UTAS Author:Schultz, MG (Dr Martin Schultz)
UTAS Author:Armstrong, MK (Mr Matthew Armstrong)
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:Sharman, JE (Professor James Sharman)
ID Code:144736
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-06-07
Last Modified:2021-06-07
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