open access

Vol 23, No 4 (2019)
ORIGINAL PAPERS
Published online: 2019-12-16
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Central-to-peripheral systolic blood pressure different phenotypes and relation to accuracy of daily used cuff devices

Ahmed Bendary, Mina Magdy, Sahar Abdoul Aal, Hisham Rashid
DOI: 10.5603/AH.a2019.0019
·
Arterial Hypertension 2019;23(4):263-270.

open access

Vol 23, No 4 (2019)
ORIGINAL PAPERS
Published online: 2019-12-16

Abstract

Background. Cuff blood pressure (BP) measurement has been the standard method for taking BP in routine daily practice for more than a century. However, some concerns were raised about the accuracy of this method which could lead to misclassification of BP in many situations. We aimed primarily to confirm a recent major discovery that distinct BP phenotypes based on central-to-peripheral systolic blood pressure (SBP) amplification do exist, and whether application of a validated cuff BP method (e.g. oscillometric) could accurately discriminate these differences.

Material and methods. Among 106 participants (mean age 62 ± 11; 58% males) undergoing coronary angiography, intra-arterial BP was measured at 3 points (ascending aorta, brachial and radial arteries). Central-to-peripheral SBP amplification (SBPamp) was defined as ≥ 5 mm Hg SBP increased from aorta-to-brachial and/or from brachial-to-radial arteries. A validated cuff BP device (oscillometric) was used to measure BP at 4 different time points.

Results. Four different BP phenotypes were confirmed based on the magnitude of SBPamp; phenotype-I, both aortic-to brachial and brachial-to radial SBPamp; phenotype-II, only aortic-to-brachial SBPamp; phenotype-III, only brachial-to-radial SBPamp; and phenotype-IV, no SBPamp at all. Aortic SBP was significantly higher in phenotypes-III and IV compared to phenotypes-I and II (p = 0.001). This was not discriminated using a validated cuff BP device measurement (p = 0.996). Results for the pulse pressure (PP) followed the same pattern.

Conclusion. Distinct BP phenotypes do exist based on SBPamp. A validated cuff BP method failed to discriminate this. Improving quality of BP measurements in daily practice is a priority.

Abstract

Background. Cuff blood pressure (BP) measurement has been the standard method for taking BP in routine daily practice for more than a century. However, some concerns were raised about the accuracy of this method which could lead to misclassification of BP in many situations. We aimed primarily to confirm a recent major discovery that distinct BP phenotypes based on central-to-peripheral systolic blood pressure (SBP) amplification do exist, and whether application of a validated cuff BP method (e.g. oscillometric) could accurately discriminate these differences.

Material and methods. Among 106 participants (mean age 62 ± 11; 58% males) undergoing coronary angiography, intra-arterial BP was measured at 3 points (ascending aorta, brachial and radial arteries). Central-to-peripheral SBP amplification (SBPamp) was defined as ≥ 5 mm Hg SBP increased from aorta-to-brachial and/or from brachial-to-radial arteries. A validated cuff BP device (oscillometric) was used to measure BP at 4 different time points.

Results. Four different BP phenotypes were confirmed based on the magnitude of SBPamp; phenotype-I, both aortic-to brachial and brachial-to radial SBPamp; phenotype-II, only aortic-to-brachial SBPamp; phenotype-III, only brachial-to-radial SBPamp; and phenotype-IV, no SBPamp at all. Aortic SBP was significantly higher in phenotypes-III and IV compared to phenotypes-I and II (p = 0.001). This was not discriminated using a validated cuff BP device measurement (p = 0.996). Results for the pulse pressure (PP) followed the same pattern.

Conclusion. Distinct BP phenotypes do exist based on SBPamp. A validated cuff BP method failed to discriminate this. Improving quality of BP measurements in daily practice is a priority.

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Keywords

blood pressure; catheterization; phenotypes; cuff devices

About this article
Title

Central-to-peripheral systolic blood pressure different phenotypes and relation to accuracy of daily used cuff devices

Journal

Arterial Hypertension

Issue

Vol 23, No 4 (2019)

Pages

263-270

Published online

2019-12-16

DOI

10.5603/AH.a2019.0019

Bibliographic record

Arterial Hypertension 2019;23(4):263-270.

Keywords

blood pressure
catheterization
phenotypes
cuff devices

Authors

Ahmed Bendary
Mina Magdy
Sahar Abdoul Aal
Hisham Rashid

References (21)
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