Artery Research

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Volume 24, Issue C, December 2018, Pages 73 - 74

3.5 CUFF BLOOD PRESSURE IS PROGRESSIVELY MORE BIASED WITH INCREASING AGE: INDIVIDUAL PARTICIPANT LEVEL ANALYSIS FROM THE INSPECT CONSORTIUM

Authors
Dean Picone1, Martin Schultz2, Petr Otahal3, Ahmed Al-Jumaily4, J. Andrew Black2, Willem Bos5, Chen-Huan Chen6, Hao-Min Chen7, Antoine Cremer8, Nathan Dwyer2, Ricardo Fonseca Diaz2, Brian Gould9, Alun Hughes10, Hack-Lyoung Kim11, Peter Lacy12, Esben Laugesen13, Sandy Muecke14, Nobuyuki Ohte15, Stefano Omboni16, Christian Ott17, Xiaoqing Peng2, Telmo Pereira18, Giacomo Pucci19, Philip Roberts-Thomson2, Niklas Rossen13, Roland Schmieder17, Velandai Srikanth2, Ralph Stewart20, George Stouffer21, Daisuke Sueta22, Kenji Takazawa23, Ji-Guang Wang24, Thomas Weber25, Berend Westerhof26, Bryan Williams10, Hirotsugu Yamada27, Eiichiro Yamamoto22, James Sharman2
1Menzies Institute for Medical Research, Hobart, Australia
2Menzies Institute for Medical Research, University of Tasmania, Australia
3Menzies Institute for Medical Research University of Tasmania, Australia
4Institute of Biomedical Technologies, Auckland University of Technology, Australia
5Department of Internal Medicine, St Antonius Hospital, Australia
6Department of Medicine, National Yang-Ming University, Taiwan
7Department of Medicine, National Yang-Ming University Taiwan, Taiwan
8Department of Cardiology/Hypertension University Hospital of Bordeaux, France
9Department of Cardiology, BMI Hospital Blackheath, UK
10Institute of Cardiovascular Sciences, University College London, UK
11Division of Cardiology, Seoul National University, South Korea
12Institute of Cardiovascular Sciences, University College, Australia
13Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark
14Department of Critical Care Medicine, Flinders University, Australia
15Department of Cardio-Renal Medicine and Hypertension, Nagoya City University, Australia
16Clinical Research Unit, Italian Institute of Telemedicine, Italy
17Department of Nephrology and Hypertension, Friedrich-Alexander University, Germany
18Department of Cardiopneumology, Polytechnic Institute of Coimbra, Portugal
19Department of Medicine, University of Perugia, Italy
20Green Lane Cardiovascular Service, University of Auckland, New Zealand
21Division of Cardiology, University of North Carolina at Chapel Hill, USA
22Department of Cardiovascular Medicine, Kumamoto University, Australia
23Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Japan
24School of Medicine, Shanghai Jiao Tong University, China
25Cardiology Department, Klinikum Wels-Grieskirchen, UK
26Department of Pulmonary Diseases, VU University Medical Center, the Netherlands
27Department of Cardiovascular Medicine, Tokushima University Hospital, Japan
Available Online 4 December 2018.
DOI
10.1016/j.artres.2018.10.036How to use a DOI?
Abstract

Objectives: Accurate blood pressure (BP) measurement is critical for appropriate hypertension diagnosis and management. Aortic BP represents pressure loading on vital organs and this can be approximated using upper arm cuff BP. With advancing age, cuff systolic BP (SBP) increases and diastolic BP (DBP) decreases (widening pulse pressure [PP]), but whether age may influence cuff BP compared with invasive BP is unknown and was the aim of this study.

Methods: Cuff BP was measured simultaneously, or near-simultaneously, with invasive aortic BP during catheterization in 1696 individuals within the INSPECT consortium (an international collaboration comprising data from 31 studies and 19 different cuff BP devices [17 oscillometric, 2 mercury sphygmomanometry]). Differences in cuff and invasive BP were assessed using mixed models.

Results: Subjects were aged 63.3 ± 10.6 years and 32% female. Cuff SBP overestimated invasive aortic SBP in those aged 40–49, but with increasing age there was a progressive increase in the underestimation of aortic SBP (Table). Conversely, cuff DBP systematically overestimated aortic DBP, increasingly with age. Thus, there was a progressively higher error (underestimation) in cuff PP with older age. Adjusting models for sex, mean arterial pressure, heart rate and catheter type did not alter the findings, and no interactions between these parameters and age were found.

Conclusion: Cuff BP is progressively more biased with increasing age, exposing older people to greater chance for misdiagnosis of risk related to BP. The findings highlight the need to improve cuff BP methods to ensure all people receive appropriate diagnosis and management of hypertension.

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<Previous Article In Issue
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Journal
Artery Research
Volume-Issue
24 - C
Pages
73 - 74
Publication Date
2018/12/04
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2018.10.036How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Dean Picone
AU  - Martin Schultz
AU  - Petr Otahal
AU  - Ahmed Al-Jumaily
AU  - J. Andrew Black
AU  - Willem Bos
AU  - Chen-Huan Chen
AU  - Hao-Min Chen
AU  - Antoine Cremer
AU  - Nathan Dwyer
AU  - Ricardo Fonseca Diaz
AU  - Brian Gould
AU  - Alun Hughes
AU  - Hack-Lyoung Kim
AU  - Peter Lacy
AU  - Esben Laugesen
AU  - Sandy Muecke
AU  - Nobuyuki Ohte
AU  - Stefano Omboni
AU  - Christian Ott
AU  - Xiaoqing Peng
AU  - Telmo Pereira
AU  - Giacomo Pucci
AU  - Philip Roberts-Thomson
AU  - Niklas Rossen
AU  - Roland Schmieder
AU  - Velandai Srikanth
AU  - Ralph Stewart
AU  - George Stouffer
AU  - Daisuke Sueta
AU  - Kenji Takazawa
AU  - Ji-Guang Wang
AU  - Thomas Weber
AU  - Berend Westerhof
AU  - Bryan Williams
AU  - Hirotsugu Yamada
AU  - Eiichiro Yamamoto
AU  - James Sharman
PY  - 2018
DA  - 2018/12/04
TI  - 3.5 CUFF BLOOD PRESSURE IS PROGRESSIVELY MORE BIASED WITH INCREASING AGE: INDIVIDUAL PARTICIPANT LEVEL ANALYSIS FROM THE INSPECT CONSORTIUM
JO  - Artery Research
SP  - 73
EP  - 74
VL  - 24
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2018.10.036
DO  - 10.1016/j.artres.2018.10.036
ID  - Picone2018
ER  -