Artery Research

Volume 25, Issue Supplement 1, December 2019, Pages S152 - S152

P112 Influence of Cuff Blood Pressure Accuracy on Identification of Isolated Systolic Hypertension

Authors
Dean Picone1, *, Martin Schultz1, Matthew Armstrong1, Willem Bos2, 3, Nathan Dwyer4, 5, Peter Lacy6, Esben Laugesen7, Stefano Omboni8, 9, Giacomo Pucci10, Philip Roberts-Thomson5, 1, George Stouffer11, Kenji Takazawa12, Thomas Weber13, Berend Westerhof14, James Sharman15
1Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Australia
2St Antonius Hospital, Department of Internal Medicine, Nieuwegein, The Netherlands
3Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
4Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia
5Royal Hobart Hospital, Hobart, Australia
6UCL Institute of Cardiovascular Science
7Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
8Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
9Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Moscow, Russian Federation
10Unit of Internal Medicine at Terni University Hospital, Department of Medicine, University of Perugia, Perugia, Italy
11Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, United States
12Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Tokyo, Japan
13Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria
14Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands
15Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia
*Corresponding author. Email: dean.picone@utas.edu.au
Corresponding Author
Dean Picone
Available Online 17 February 2020.
DOI
https://doi.org/10.2991/artres.k.191224.138How to use a DOI?
Abstract

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.

Copyright
© 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Artery Research
Volume-Issue
25 - Supplement 1
Pages
S152 - S152
Publication Date
2020/02
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
https://doi.org/10.2991/artres.k.191224.138How to use a DOI?
Copyright
© 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
Open Access
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  -