Identifying Isolated Systolic Hypertension From Upper-Arm Cuff Blood Pressure Compared With Invasive Measurements

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  • Dean S Picone, Univ Tasmania, University of Tasmania, Sch Med
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  • Martin G Schultz, University of Tasmania
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  • Matthew K Armstrong, University of Tasmania
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  • J Andrew Black, University of Tasmania
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  • Willem Jan W Bos, Leiden University Medical Center
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  • Chen-Huan Chen, Faculty of Medicine and Brain Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan
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  • Hao-Min Cheng, Faculty of Medicine and Brain Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan
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  • Antoine Cremer, Department of Cardiology/Hypertension, University Hospital of Bordeaux, Bordeaux, France.
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  • Nathan Dwyer, Univ Tasmania, University of Tasmania, Sch Med
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  • Alun D Hughes, Univ Coll London Hosp NHS Fdn Trust, University College London Hospitals NHS Foundation Trust, University of London, University College London, Inst Nucl Med
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  • Hack-Lyoung Kim, Department of Neurology, Seoul National University Boramae Hospital, Seoul, South Korea.
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  • Peter S Lacy, Institute of Cardiovascular Sciences University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, London, United Kingdom.
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  • Esben Laugesen
  • Fuyou Liang, Shanghai Jiao Tong University, Sechenov First Moscow State Medical University
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  • Nobuyuki Ohte, Nagoya City University
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  • Sho Okada, Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
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  • Stefano Omboni, Sechenov First Moscow State Medical University, Italian Institute of Telemedicine
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  • Christian Ott, Friedrich-Alexander University Erlangen-Nürnberg
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  • Telmo Pereira, Polytechnic Institute of Coimbra
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  • Giacomo Pucci, University of Perugia
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  • Roland E Schmieder, Friedrich-Alexander University Erlangen-Nürnberg
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  • Manish D Sinha, Kings College, London
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  • George A Stouffer, University of North Carolina at Chapel Hill
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  • Kenji Takazawa, Tokyo Medical and Dental University Hospital
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  • Philip Roberts-Thomson, University of Tasmania
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  • Ji-Guang Wang, Shanghai Jiao Tong University
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  • Thomas Weber, Klinikum Wels-Grieskirchen
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  • Berend E Westerhof, University of Twente
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  • Bryan Williams, University College London
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  • James E Sharman, University of Tasmania
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  • Invasive Blood Pressure Consortium

Isolated systolic hypertension (ISH) is the most common form of hypertension and is highly prevalent in older people. We recently showed differences between upper-arm cuff and invasive blood pressure (BP) become greater with increasing age, which could influence correct identification of ISH. This study sought to determine the difference between identification of ISH by cuff BP compared with invasive BP. Cuff BP and invasive aortic BP were measured in 1695 subjects (median 64 years, interquartile range [55-72], 68% male) from the INSPECT (Invasive Blood Pressure Consortium) database. Data were recorded during coronary angiography among 29 studies, using 21 different cuff BP devices. ISH was defined as ≥130/<80 mm Hg using cuff BP compared with invasive aortic BP as the reference. The prevalence of ISH was 24% (n=407) according to cuff BP but 38% (n=642) according to invasive aortic BP. There was fair agreement (Cohen κ, 0.36) and 72% concordance between cuff and invasive aortic BP for identifying ISH. Among the 28% of subjects (n=471) with misclassification of ISH status by cuff BP, 20% (n=96) of the difference was due to lower cuff systolic BP compared with invasive aortic systolic BP (mean, -16.4 mm Hg [95% CI, -18.7 to -14.1]), whereas 49% (n=231) was from higher cuff diastolic BP compared with invasive aortic diastolic BP (+14.2 mm Hg [95% CI, 11.5-16.9]). In conclusion, compared with invasive BP, cuff BP fails to identify ISH in a sizeable portion of older people and demonstrates the need to improve cuff BP measurements.

OriginalsprogEngelsk
TidsskriftHypertension (Dallas, Tex. : 1979)
Vol/bind77
Nummer2
Sider (fra-til)632-639
Antal sider8
ISSN0194-911X
DOI
StatusUdgivet - feb. 2021

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