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Review
. 2022 Dec;54(12):102514.
doi: 10.1016/j.aprim.2022.102514. Epub 2022 Nov 21.

[Interarm blood pressure difference: Concordance between two methods of automatic simultaneous measurement and between visits reproducibility]

[Article in Spanish]
Nuria Martínez-Sánchez  1 , Antonio Palasí  2 , Guillem Pera  3 , Luis Miguel Martínez  4 , Raquel Albaladejo  5 , Pere Torán  3
Affiliations
Review

[Interarm blood pressure difference: Concordance between two methods of automatic simultaneous measurement and between visits reproducibility]

[Article in Spanish]
Nuria Martínez-Sánchez et al. Aten Primaria. 2022 Dec.

Abstract
in English, Spanish

Objective: An increased interarm blood pressure difference (IAD) (≥10mmHg) has been associated with increased cardiovascular morbidity and mortality. There are few studies determining how IAD has to be measured and its reliability between visits. The objectives of our study were twofold. First, to evaluate the concordance between two automatic oscillometric devices for IAD measurement (two OMRON devices and one Microlife WatchBP™ device (WBP™)) and to analyse the reproducibility of IAD between visits in the general population attending a primary care centre.

Design: Descriptive cross-sectional study of concordance between the two methods and reproducibility of IAD between two visits separated by one week. SITE: Parets del Vallès primary care centre (Barcelona).

Participants: General population aged 35-74 years.

Interventions and main measurements: One hundred and forty-nine patients completed the two visits. At each visit, IAD was measured three times with both methods and the mean of the three determinations was considered. Other variables such as sociodemographic and anthropometric variables, pathological antecedents and pharmacological treatment were collected through a review of the medical history and an interview with the patient. Concordance between the two devices and between visits reproducibility were calculated using the Lin concordance coefficient (CCL) for IAD expressed continuously and kappa(k) indices for IAD categorised as normal or pathological.

Results: Concordance for IAD expressed continuously was low: CCL=0.13 (0.02-0.24). Concordance was also low for IAD categorised as normal or pathological (k=-0.03 (-0.05-0.00)). Reproducibility between visits was low for both methods and for both continuous and categorised IAD: with OMRON™ CCL=0.19 (0.03-0.34) and k=-0.02 (-0.16-0.12) and for WBP™ CCL=0.14 (-0.01-0.29) and k=0.49 (0.33-0.64).

Conclusions: Concordance between two automatic oscillometers in the simultaneous IAD measurement was low. Reproducibility between visits was also low for both methods.

Objetivo: La diferencia de presión arterial sistólica entre brazos (dPEB) aumentada (≥ 10 mmHg) se ha relacionado con mayor morbimortalidad cardiovascular. Hay poca evidencia sobre cómo determinar la dPEB y su fiabilidad ha sido poco estudiada. Nuestros objetivos fueron evaluar la concordancia entre 2 oscilómetros automáticos de medición simultánea de la dPEB (2 aparatos OMRON y un aparato Microlife WatchBP® [WBP]) y analizar la reproducibilidad de la dPEB entre visitas en población general atendida en un centro de atención primaria.

Diseño: Estudio descriptivo transversal de concordancia entre los 2 métodos y de fiabilidad de la dPEB entre 2 visitas separadas una semana.

Emplazamiento: Centro de Atención Primaria de Parets del Vallès, Barcelona.

Participantes: Población general de 35-74 años.

Intervenciones y mediciones principales: Ciento cuarenta y nueve pacientes completaron las 2 visitas. En cada visita se midió la dPEB 3 veces con ambos métodos, y se consideró la media de las 3 determinaciones. Mediante revisión de la historia y entrevista con el paciente se recogieron otras variables como sociodemográficas y antropométricas, antecedentes patológicos y tratamiento farmacológico. Se calculó la concordancia entre los dispositivos y la reproducibilidad entre visitas mediante el coeficiente de concordancia de Lin (CCL) para la dPEB expresada de manera continua y los índices kappa (k) para la dPEB categorizada en normal o patológica.

Resultados: La concordancia entre métodos para la dPEB expresada de forma continua fue baja: CCL: 0,13 (0,02-0,24). La concordancia fue también baja para la dPEB categorizada en normal o patológica (k = −0,03 [−0,05-0,00]). La reproducibilidad entre visitas fue baja para ambos métodos, y tanto para la dPEB continua como categorizada: con OMRON® CCL: 0,19 (0,03-0,34) y k = −0,02 (−0,16-0,12) y para WBP® CCL: 0,14 (−0,01-0,29) y k = 0,49 (0,33-0,64).

Conclusiones: La concordancia entre 2 oscilómetros automáticos en la determinación simultánea de la dPEB fue baja. La reproducibilidad entre visitas también fue baja para ambos métodos.

Keywords: Automatic oscillometer; Concordance; Concordancia; Diferencia de presión arterial entre brazos; Interarm blood pressure difference; Oscilómetro automático; Reproducibilidad; Reproducibility.

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Figures

Figura 1
Figura 1
Diagrama de flujo de los pacientes del estudio.
Figura 2
Figura 2
Diagrama de dispersión (izquierda) para la concordancia de la medida de la dPEB con OMRON y WBP (usando la media de las 3 determinaciones) y su correspondiente gráfico de Bland-Altman (derecha).
Figura 3
Figura 3
Diagramas de dispersión (izquierda) para la reproducibilidad entre la visita 1 (v1) y 2 (v2) de la dPEB con OMRON y WBP, usando la media de la triple toma y sus correspondientes gráficos de Bland-Altman (derecha).
See this image and copyright information in PMC

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