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Impact of calibration on estimates of central blood pressures

(2012) JOURNAL OF HUMAN HYPERTENSION. 26(12). p.706-710
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Abstract
Using the Sphygmocor device it is recommended that the radial pressure wave is calibrated for brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP). However it has been suggested that brachial-to-radial pressure amplification causes underestimation of central blood pressures (BPs) using this calibration. In the present study we examined if different calibrations had an impact on estimates of central BPs and on the clinical interpretation of our results. On the basis of ambulatory BP measurements, patients were categorized into patients with controlled, uncontrolled or resistant hypertension. We first calibrated the radial pressure wave as recommended and afterwards recalibrated the same pressure wave using brachial DBP and calculated mean arterial pressure. Recalibration of the pressure wave generated significantly higher estimates of central SBP (P = 0.0003 and P<0.0001 at baseline and P<0.0001 and P = 0.0002 after 6 months). Using recommended calibration we found a significant change in central SBP in both treatment groups (P = 0.05 and P = 0.01), however, after recalibrating significance was lost in patients with resistant hypertension (P = 0.15). We conclude that calibration with DBP and mean arterial pressure produces higher estimates of central BPs than recommended calibration. The present study also shows that this difference between the two calibration methods can produce more than a systematic error and has an impact on interpretation of clinical results.
Keywords
calibration, pulse pressure amplification, sphygmocor, central blood pressure, NONINVASIVE ASSESSMENT, CLINICAL-APPLICATIONS, CONSENSUS DOCUMENT, ARTERIAL STIFFNESS, AORTIC PRESSURE, PULSE PRESSURE, RECOMMENDATIONS, AMPLIFICATION, HYPERTENSION, STATEMENT

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Citation

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Chicago
Soender, TK, Lucas Van Bortel, JE Moller, J Lambrechtsen, J Hangaard, and K Egstrup. 2012. “Impact of Calibration on Estimates of Central Blood Pressures.” Journal of Human Hypertension 26 (12): 706–710.
APA
Soender, TK, Van Bortel, L., Moller, J., Lambrechtsen, J., Hangaard, J., & Egstrup, K. (2012). Impact of calibration on estimates of central blood pressures. JOURNAL OF HUMAN HYPERTENSION, 26(12), 706–710.
Vancouver
1.
Soender T, Van Bortel L, Moller J, Lambrechtsen J, Hangaard J, Egstrup K. Impact of calibration on estimates of central blood pressures. JOURNAL OF HUMAN HYPERTENSION. 2012;26(12):706–10.
MLA
Soender, TK, Lucas Van Bortel, JE Moller, et al. “Impact of Calibration on Estimates of Central Blood Pressures.” JOURNAL OF HUMAN HYPERTENSION 26.12 (2012): 706–710. Print.
@article{3128941,
  abstract     = {Using the Sphygmocor device it is recommended that the radial pressure wave is calibrated for brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP). However it has been suggested that brachial-to-radial pressure amplification causes underestimation of central blood pressures (BPs) using this calibration. In the present study we examined if different calibrations had an impact on estimates of central BPs and on the clinical interpretation of our results. On the basis of ambulatory BP measurements, patients were categorized into patients with controlled, uncontrolled or resistant hypertension. We first calibrated the radial pressure wave as recommended and afterwards recalibrated the same pressure wave using brachial DBP and calculated mean arterial pressure. Recalibration of the pressure wave generated significantly higher estimates of central SBP (P = 0.0003 and P{\textlangle}0.0001 at baseline and P{\textlangle}0.0001 and P = 0.0002 after 6 months). Using recommended calibration we found a significant change in central SBP in both treatment groups (P = 0.05 and P = 0.01), however, after recalibrating significance was lost in patients with resistant hypertension (P = 0.15). We conclude that calibration with DBP and mean arterial pressure produces higher estimates of central BPs than recommended calibration. The present study also shows that this difference between the two calibration methods can produce more than a systematic error and has an impact on interpretation of clinical results.},
  author       = {Soender, TK and Van Bortel, Lucas and Moller, JE and Lambrechtsen, J and Hangaard, J and Egstrup, K},
  issn         = {0950-9240},
  journal      = {JOURNAL OF HUMAN HYPERTENSION},
  language     = {eng},
  number       = {12},
  pages        = {706--710},
  title        = {Impact of calibration on estimates of central blood pressures},
  url          = {http://dx.doi.org/10.1038/jhh.2011.97},
  volume       = {26},
  year         = {2012},
}

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