Comparison of central blood pressure estimated by a cuff-based device with radial tonometry

Peng, Xiaoqing , Schultz, Martin G., Abhayaratna, Walter P. , Stowasser, Michael and Sharman, James E. (2016) Comparison of central blood pressure estimated by a cuff-based device with radial tonometry. American Journal of Hypertension, 29 10: 1173-1178. doi:10.1093/ajh/hpw063


Author Peng, Xiaoqing 
Schultz, Martin G.
Abhayaratna, Walter P. 
Stowasser, Michael
Sharman, James E.
Title Comparison of central blood pressure estimated by a cuff-based device with radial tonometry
Journal name American Journal of Hypertension   Check publisher's open access policy
ISSN 1941-7225
0895-7061
Publication date 2016-10-01
Sub-type Article (original research)
DOI 10.1093/ajh/hpw063
Open Access Status Not yet assessed
Volume 29
Issue 10
Start page 1173
End page 1178
Total pages 6
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Subject 2724 Internal Medicine
Abstract BACKGROUND New techniques that measure central blood pressure (BP) using an upper arm cuff-based approach require performance assessment. The aim of this study was to compare a cuff-based device (Cuff) to estimate central BP indices (systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), augmentation pressure (AP), augmentation index (AIx)) with noninvasive radial tonometry (Ton). METHODS Consecutive Cuff (SphygmoCor Xcel) and Ton (SphygmoCor 8.1) duplicate recordings were measured in 182 people with treated hypertension (aged 61±7 years, 48% male). Agreement between methods was assessed using standard calibration with brachial SBP and DBP (measured with the Xcel device), as well as with brachial mean arterial pressure (MAP; 40% form factor method) and DBP. RESULTS The mean difference ± SD for central SBP (cSBP), central DBP (cDBP), and central PP (cPP) between methods were -0.89±3.48mm Hg (intra-class correlation (ICC) 0.977; 95% confidence interval (CI) 0.973-0.982), -0.50±1.54mm Hg (ICC 0.992, 95% CI 0.987-0.993), and -0.42±3.57mm Hg (ICC 0.966, 95% CI 0.958-0.972), indicating good agreement. Wider limits of agreement were observed for central AP (cAP) and central AIx (cAIx) (-0.91±5.31mm Hg; ICC 0.802; 95% CI 0.756-0.839, -0.99±10.91%; ICC 0.749; 95% CI 0.691-0.796). Re-calibration with brachial MAP and DBP resulted in an overestimation of cSBP with Cuff compared with Ton (8.58±19.06mm Hg, ICC 0.164, 95% CI -0.029 to 0.321). CONCLUSION cSBP, cDBP, and cPP derived from Cuff are substantially equivalent to Ton although the level of agreement is dependent on calibration method. Further validity testing of Cuff by comparison with invasively measured central BP will be required.
Formatted abstract
Background: New techniques that measure central blood pressure (BP) using an upper arm cuff-based approach require performance assessment. The aim of this study was to compare a cuff-based device (CuffCBP) to estimate central BP indices (systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), augmentation pressure (AP), augmentation index (AIx)) with noninvasive radial tonometry (TonCBP).

Methods: Consecutive CuffCBP (SphygmoCor Xcel) and TonCBP (SphygmoCor 8.1) duplicate recordings were measured in 182 people with treated hypertension (aged 61±7 years, 48% male). Agreement between methods was assessed using standard calibration with brachial SBP and DBP (measured with the Xcel device), as well as with brachial mean arterial pressure (MAP; 40% form factor method) and DBP.

Results: The mean difference ± SD for central SBP (cSBP), central DBP (cDBP), and central PP (cPP) between methods were -0.89±3.48mm Hg (intra-class correlation (ICC) 0.977; 95% confidence interval (CI) 0.973-0.982), -0.50±1.54mm Hg (ICC 0.992, 95% CI 0.987-0.993), and -0.42±3.57mm Hg (ICC 0.966, 95% CI 0.958-0.972), indicating good agreement. Wider limits of agreement were observed for central AP (cAP) and central AIx (cAIx) (-0.91±5.31mm Hg; ICC 0.802; 95% CI 0.756-0.839, -0.99±10.91%; ICC 0.749; 95% CI 0.691-0.796). Re-calibration with brachial MAP and DBP resulted in an overestimation of cSBP with CuffCBP compared with TonCBP (8.58±19.06mm Hg, ICC 0.164, 95% CI -0.029 to 0.321).

Conclusion: cSBP, cDBP, and cPP derived from CuffCBP are substantially equivalent to TonCBP, although the level of agreement is dependent on calibration method. Further validity testing of CuffCBP by comparison with invasively measured central BP will be required.
Keyword Arterial blood pressure
Blood pressure
Blood pressure determination
Diagnostic equipment
Hemodynamics
Hypertension
Oscillometry
Pulse wave analysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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Sub-type: Article (original research)
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