P112 Influence of Cuff Blood Pressure Accuracy on Identification of Isolated Systolic Hypertension
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Introduction: Isolated systolic hypertension (ISH) is the most common form of hypertension in older people. However, accurate identification of ISH may be hindered because cuff blood pressure (BP) underestimates systolic BP (SBP) and overestimates diastolic BP (DBP). This study aimed to determine the influence of cuff BP accuracy on the identification of ISH.
Methods: Cuff BP and invasive aortic BP were measured simultaneous (or near-simultaneously) in 1737 subjects (63 ± 12 years, 68% male) during coronary angiography. Data was derived from 32 studies, using 20 different cuff BP devices, from the Invasive Blood Pressure Consortium (INSPECT). ISH was defined as ≥140/<90 mmHg according to cuff BP and invasive aortic BP.
Results: According to cuff BP, 25% of subjects (n = 430) had ISH, however, 37% (n = 648) were identified with ISH from invasive aortic BP. There was 77% concordance between cuff and invasive BP for identifying ISH. Among the 23% (n = 408) of subjects misclassified by cuff BP, 38% (n = 155) of misclassification was from SBP underestimation (mean: −16.6, 95% CI: −18.9 to −13.9 mmHg), whereas 35% (n = 143) was from DBP overestimation (15.6, 11.9 to 19.0 mmHg) and 20% (n = 83) from SBP overestimation (17.6, 14.4 to 20.5 mmHg). Subjects misclassified were on average 2.7 years older and had greater body mass index (0.8 kg/m2) than those correctly classified.
Conclusion: Approximately one quarter of older subjects have ISH misclassified, mostly because of underestimation of cuff SBP and overestimation of cuff DBP. This demonstrates a need to improve the accuracy of cuff BP methods for greater precision in identifying ISH.
- © 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
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- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
Cite this article
TY - JOUR AU - Dean Picone AU - Martin Schultz AU - Matthew Armstrong AU - Willem Bos AU - Nathan Dwyer AU - Peter Lacy AU - Esben Laugesen AU - Stefano Omboni AU - Giacomo Pucci AU - Philip Roberts-Thomson AU - George Stouffer AU - Kenji Takazawa AU - Thomas Weber AU - Berend Westerhof AU - James Sharman PY - 2020 DA - 2020/02 TI - P112 Influence of Cuff Blood Pressure Accuracy on Identification of Isolated Systolic Hypertension JO - Artery Research SP - S152 EP - S152 VL - 25 IS - Supplement 1 SN - 1876-4401 UR - https://doi.org/10.2991/artres.k.191224.138 DO - https://doi.org/10.2991/artres.k.191224.138 ID - Picone2020 ER -