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

Dean Picone; Martin Schultz; Petr Otahal; Ahmed Al-Jumaily; J. Andrew Black; Willem Bos; Chen-Huan Chen; Hao-Min Chen; Antoine Cremer; Nathan Dwyer; Ricardo Fonseca Diaz; Brian Gould; Alun Hughes; Hack-Lyoung Kim; Peter Lacy; Esben Laugesen; Sandy Muecke; Nobuyuki Ohte; Stefano Omboni; Christian Ott; Xiaoqing Peng; Telmo Pereira; Giacomo Pucci; Philip Roberts-Thomson; Niklas Rossen; Roland Schmieder; Velandai Srikanth; Ralph Stewart; George Stouffer; Daisuke Sueta; Kenji Takazawa; Ji-Guang Wang; Thomas Weber; Berend Westerhof; Bryan Williams; Hirotsugu Yamada; Eiichiro Yamamoto; James Sharman

doi:10.1016/j.artres.2018.10.036

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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.2018.10.036 How 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.
Open Access: This is an open access article distributed under the CC BY-NC license.

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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.2018.10.036 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Cite this article

ris enw bib

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  -

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