Arterial stiffness and central blood pressure, as determined by pulse wave analysis, in rheumatoid arthritis

Abstract Children with a family history of hypertension have higher blood pressure and hypertensive pathophysiological changes begin before clinical findings. Here, the presence of arterial stiffness was investigated using central blood pressure measurement and pulse wave analysis in normotensive children with at least one parent with essential hypertension. Twenty-four-hour ambulatory pulse wave analysis monitoring was performed by oscillometric method in a study group of 112 normotensive children of hypertensive parents aged between 7 and 18 comparing with a control group of 101 age- and gender-matched normotensive children of normotensive parents. Pulse wave velocity, central systolic and diastolic blood pressure, systolic, diastolic and mean arterial blood pressure values were higher in the study group than the control group (p < 0.001, p = 0.002, p = 0.008, p = 0.001, p = 0.005, p = 0.001, p = 0.001, respectively). In all age groups (7–10, 11–14, and 15–18 years), pulse wave velocity was higher in the study group than the control group (p < 0.001). Pulse wave velocity was higher in children whose both parents are hypertensive compared to the children whose only mothers are hypertensive (p = 0.011). Pulse wave velocity values were positively correlated with age, weight, height, and body mass index (p < 0.05). Higher pulse wave velocity, central systolic and diastolic blood pressure values detected in the study group can be considered as early signs of hypertensive vascular changes. Pulse wave analysis can be a reliable, non-invasive, and reproducible method that can allow taking necessary precautions regarding lifestyle to prevent disease and target organ damage by detecting early hypertensive changes in genetically risky children.

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Automated non-invasive central blood pressure measurements by oscillometric radial pulse wave analysis – results of the MEASURE-cBP validation studies

American Journal of Hypertension ◽

10.1093/ajh/hpaa174 ◽

2020 ◽

Author(s):

Frederik Trinkmann ◽

Urs Benck ◽

Julian Halder ◽

Alexandra Semmelweis ◽

Joachim Saur ◽

...

Keyword(s):

Blood Pressure ◽

Pulse Wave ◽

Applanation Tonometry ◽

Pulse Wave Analysis ◽

Central Blood Pressure ◽

Diabetic Patients ◽

Radial Pulse ◽

Wave Analysis ◽

Operator Training ◽

Non Invasive

Abstract Background Central blood pressure becomes increasingly accepted as an important diagnostic and therapeutic parameter in the management of cardiovascular disease. This led to development of several non-invasive techniques most commonly based on peripheral pulse wave analysis. Accuracy of widespread applanation tonometry can be affected by calibration and operator training. To overcome this, we aimed to evaluate a novel device (VascAssist 2) using automated oscillometric radial pulse wave analysis and a refined multi-compartment model of the arterial tree. Methods 225 patients were prospectively enrolled. Invasive aortic root measurements served as reference in MEASURE-cBP 1 (n=106) whereas an applanation tonometry device (SphygmoCor) was used in MEASURE-cBP 2 (n=119). Results In MEASURE-cBP 1, we found a mean overestimation for systolic values of 4±12 mmHg (3±10%) and 6±10 mmHg (9±14%) for diastolic values. Diabetes mellitus and low blood pressure were associated with larger variation. In MEASURE-cBP 2, mean overestimation of systolic values was 4±4 mmHg (4±4%) and 1±4 mmHg (1±7%) of diastolic values. Arrhythmia was significantly more frequent in invalid measurements (61 vs. 18%, p<0.0001) which were most often due to a low quality index of SphygmoCor. Accuracy did not differ between patients with arrhythmia and sinus rhythm in MEASURE-cBP 1. Conclusions Central blood pressure estimates using VascAssist 2 can be considered at least as accurate as available techniques, even including diabetic patients. In direct comparison, automated measurement considerably facilitates application not requiring operator training and can be reliably applied even in patients with arrhythmias.

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Arterial stiffness assessed by pulse wave analysis in essential hypertension: relation to 24-h blood pressure profile

International Journal of Cardiology ◽

10.1016/j.ijcard.2004.04.014 ◽

2005 ◽

Vol 102 (3) ◽

pp. 391-395 ◽

Cited By ~ 51

Author(s):

John P. Lekakis ◽

Nikos A. Zakopoulos ◽

Athanasios D. Protogerou ◽

Theodoros G. Papaioannou ◽

Vassilios Th. Kotsis ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Arterial Stiffness ◽

Pulse Wave ◽

Pressure Profile ◽

Pulse Wave Analysis ◽

Wave Analysis ◽

Blood Pressure Profile

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Time to end a doubt: is pulse wave analysis a valid measure for central arterial blood pressure and arterial stiffness?

Journal of Hypertension ◽

10.1097/hjh.0b013e32802bf8bb ◽

2007 ◽

Vol 25 (3) ◽

pp. 724-725 ◽

Cited By ~ 9

Author(s):

Ali R Khoshdel

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Arterial Blood Pressure ◽

Pulse Wave ◽

Pulse Wave Analysis ◽

Valid Measure ◽

Wave Analysis ◽

Arterial Blood

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Abstract 265: Validation of a novel Brachial Pulse Wave Analysis-Based Method for Estimating Central Blood Pressure among Japanese Cardiovascular Patients

Hypertension ◽

10.1161/hyp.64.suppl_1.265 ◽

2014 ◽

Vol 64 (suppl_1) ◽

Author(s):

Toshihiro Shoji ◽

Sho Okada ◽

Atsushi Nakagomi ◽

Yoshio Kobayashi

Keyword(s):

Blood Pressure ◽

Gender Difference ◽

Linear Correlation ◽

Pulse Wave ◽

Pearson Correlation ◽

Japanese Patients ◽

Pulse Wave Analysis ◽

Central Blood Pressure ◽

Wave Analysis ◽

The Difference

Background: Hypertension is a significant predictive factor for future cardiovascular(CV) events. Historically its assessment has been made at the brachial arm, and this method is still cardinal for hypertension treatment. Blood pressure measured at the root of the aorta, named ‘central’ blood pressure (cBP), shows actual load on the heart and proximal large arteries. It has been recognized as more accurate predictor for CV events than ‘brachial’ one. Despite this, invasive maneuvers on cBP measurement have long limited its widespread clinical use. Recently several non-invasive methods were developed for cBP measurement. ARC Solver algorithm, which calculates cBP from brachial BP using novel pulse wave analysis-based method, enabled us to assess ambulatory cBP values. Though it was already validated among western countries, its accuracy nor optimal conditions still remains unknown among us Japanese. Object: To validate ARC Solver algorithm-based cBP measurement among Japanese CV patients. Method: For 89 patients who underwent elective coronary angiography in our hospital, we simultaneously measured invasive cBP (cBPinv) and calculated cBP with ARC Solver algorithm (cBPcalc) . We used systolic and diastolic BP (Calc1) or mean and diastolic BP(Calc2) for calibration. Then we evaluated the error and correlation of the data with Bland-Altman analysis and Pearson correlation analysis, respectively. After excluding the perturbing factors such as arrhythmia and valvular heart disease, we performed the same analyses. Results: cBPinv and cBPcalc showed good linear correlation (Cal1: r=0.72, p<0.01, Cal2: r=0.748, p<0.01), whereas error between them showed marked difference (Cal1: 17.7±16.3mmHg, Cal2: -7.5mmHg±18.1mmHg). After excluding perturbing factors, the difference even enlarged (Cal1: 19.9±17.0mmHg, Cal2: -3.9±15.5mmHg), although linear correlation was each improved (Cal1: r=0.76, p<0.05, Cal2: r=0.84, p<0.01). Gender difference influenced the error. Conclusions: Mode of calibration significantly influences the calculated cBP with ARC Solver algorithm among Japanese patients with CV diseases. Consideration for the perturbing clinical factors and gender difference are also essential for its proper clinical application.

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