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Comparison between cuff-based and invasive systolic blood pressure amplification
Tan V Bui1, Dean S Picone1, Martin G Schultz1
1Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Journal of Hypertension
|September 2, 2022
Summary
Cuff-based systolic blood pressure (BP) amplification measurements show bias and variability compared to invasive methods. Further research is needed to improve the accuracy of non-invasive BP monitoring devices.
Area of Science:
- Cardiovascular physiology
- Medical device technology
- Hypertension research
Background:
- Accurate central blood pressure (BP) measurement is crucial for cardiovascular risk assessment.
- Systolic blood pressure (SBP) amplification, the difference between brachial and central SBP, is an important hemodynamic parameter.
- Upper arm cuff-based methods are widely used for BP measurement, but their accuracy in determining SBP amplification needs validation against invasive techniques.
Purpose of the Study:
- To evaluate the agreement between cuff-based and invasively measured systolic blood pressure (SBP) amplification.
- To assess the performance of two different central BP devices in estimating SBP amplification.
Main Methods:
- Simultaneous invasive and cuff-based SBP amplification measurements were performed in patients undergoing coronary angiography.
- Two central BP devices were used: Sphygmocor Xcel (device 1, n=171) and Uscom BP+ (device 2, n=52).
- Statistical analysis included calculating mean differences, limits of agreement, and concordance across SBP amplification quartiles.
Main Results:
- Device 1 showed a mean difference of 4 mmHg (-12, +20 mmHg) and Device 2 showed -2 mmHg (-14, +10 mmHg) compared to invasive measurements.
- Both devices exhibited systematic bias, overestimating SBP amplification at lower levels and underestimating at higher levels.
- Concordance was low, especially in the lowest and highest quartiles of invasive SBP amplification; however, cuff-based estimates had less individual variability.
Conclusions:
- Cuff-based SBP amplification measurements demonstrate proportional systematic bias when compared to invasive methods.
- Despite biases, cuff-based methods exhibit lower individual variability, suggesting potential for improvement in non-invasive central BP monitoring.
- Findings provide insights for enhancing the performance of cuff-based central BP measurement devices.
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