Methodological evaluation of the noninvasive estimation of central systolic blood pressure in nontreated patients: the Bogalusa Heart Study

Abstract

Objectives: This study sought to compare the estimation of central systolic blood pressure (cSBP) obtained by two different noninvasive devices, in addition to its comparisons with measured peripheral systolic blood pressure (pSBP), in a biracial (Black/White) community-based cohort.

Participants and methods: Estimations of cSBP by applanation tonometry were obtained in 586 participants of the Bogalusa Heart Study (mean age: 43.5 years; 69% White, 54% women) using two different commonly used instruments: Omron HEM-9000AI and SphygmoCor CPV. pSBP was measured using a standard auscultatory technique.

Results: The estimation of cSBP by the Omron device was higher than that of the SphygmoCor device (124.2±17.1 vs. 111.4±15.2 mmHg, P<0.001). Moreover, cSBP by Omron was significantly higher than peripheral blood pressure (124.2±17.1 vs. 119.4±15.6 mmHg, P<0.001), whereas cSBP by SphygmoCor was significantly lower than pSBP (111.4±15.2 vs. 119.4±15.6 mmHg, P<0.001). Similar results were observed in race-specific and sex-specific analyses.

Conclusion: These findings support the hypothesis that notable differences exist in the estimation of cSBP provided by the instruments utilized in this study. Further standardization studies are required to establish the most appropriate noninvasive estimation of cSBP before this parameter may be considered in the assessment, prediction, and prevention of cardio-metabolic risk and overt cardiovascular disease in clinical practice.

Figure 1:

Mean comparisons of central systolic blood pressure (Omron vs. SphygmoCor) and peripheral systolic blood pressure (auscultatory)

Figure 2:

Race- and Sex- specific mean comparisons of central systolic blood pressure (Omron vs. SphygmoCor) and peripheral systolic blood pressure (auscultatory) *, comparison between cSBP Omron and cSBP Sphygmocor (p<0.001) †, comparison between cSBP Omron and pSBP Auscultatory (p<0.001) ‡, comparison between cSBP Sphygmocor and pSBP Auscultatory (p<0.001) cSBP, central systolic blood pressure; pSBP, peripheral systolic blood pressure

Figure 3:

Correlation of cSBP by Omron and Sphygmocor by sex group. r, correlation coefficient; R², coefficient of determination cSBP Omron, central systolic blood pressure obtained by the Omron HEM 9000 AI instrument; cSBP Sphygmocor, central systolic blood pressure obtained by the Sphygmocor CPV instrument.

Figure 4:

Correlation of cSBP by Omron and Sphygmocor by race group. r, correlation coefficient; R², coefficient of determination cSBP Omron, central systolic blood pressure obtained by the Omron HEM 9000 AI instrument; cSBP Sphygmocor, central systolic blood pressure obtained by the Sphygmocor CPV instrument.