Cardiovascular Research Group, University of Manchester and Manchester Academic Health Centre, Manchester, UK.
Hypertens Res. 2011 Sep;34(9):1046-51. doi: 10.1038/hr.2011.75. Epub 2011 Jul 14.
The objective of this study was to compare central systolic blood pressure (cSBP) and augmentation index (AIx) from two recently introduced devices, Omron HEM-9000 (OM) and Arteriograph (AG), not using a transfer function with those of the widely used SphygmoCor (SC) calibrated on brachial blood pressure like OM. Random-order manufacturer-recommended measurements using SC and OM by radial tonometry and AG were taken on the left arm in 35 men (54±10 years) after 5 min supine rest. Results are means (95% confidence interval) of differences using paired t-tests. cSBP by OM was 4.1 (1.0-7.1) mm Hg higher than by AG. Both OM and AG estimated the mean cSBP to be significantly higher than did SC (114.8 mm Hg) by 12.5 (10.3-14.7) and 8.6 (4.9-12.3) mm Hg, respectively, although closely correlating with SC (r=0.9). Calibrating SC with diastolic blood pressure (DBP) and more accurate mean arterial pressure (as DBP+0.4 × PP) resulted in significantly higher cSBP statistically not different from AG's cSBP: 0.9 (-1.1 to +2.9) mm Hg, and closer to OM's: 5.1 (3.4-6.8) mm Hg. Radial AIx from SC and OM disagreed by 3 (0.7-5.4)%, and correlated (r=0.8) with AG's brachial AIx. AG's aortic AIx was 7.9 (5.7-10.2)% higher than SC's, but closely correlated (r=0.9). Clinically significant, higher cSBP measured by AG, OM and more accurately calibrated SC adds to previous data suggesting that SC measurements by classic calibration underestimate cSBP. Invasive studies involving all three devices would be more illuminating.
本研究旨在比较两种新引入的设备——欧姆龙 HEM-9000(OM)和动脉造影仪(AG)的中心收缩压(cSBP)和增强指数(AIx),与广泛使用的经肱动脉血压校准的 SphygmoCor(SC)相比,不使用传递函数。35 名男性(54±10 岁)在 5 分钟仰卧休息后,使用桡动脉张力计随机顺序制造商推荐的 SC 和 OM 进行测量,以及使用 AG 进行测量。结果为配对 t 检验差值的平均值(95%置信区间)。与 AG 相比,OM 的 cSBP 高 4.1(1.0-7.1)mmHg。OM 和 AG 估计的平均 cSBP 均显著高于 SC(114.8mmHg),分别高 12.5(10.3-14.7)和 8.6(4.9-12.3)mmHg,尽管与 SC 相关性良好(r=0.9)。用舒张压(DBP)和更准确的平均动脉压(作为 DBP+0.4×PP)校准 SC,会使 cSBP 显著升高,统计学上与 AG 的 cSBP 无差异:0.9(-1.1 至+2.9)mmHg,与 OM 更接近:5.1(3.4-6.8)mmHg。SC 和 OM 的桡动脉 AIx 差异为 3(0.7-5.4)%,与 AG 的肱动脉 AIx 相关(r=0.8)。AG 的主动脉 AIx 比 SC 高 7.9(5.7-10.2)%,但相关性良好(r=0.9)。AG、OM 测量的 cSBP 和更准确校准的 SC 均显著升高,这增加了之前的数据提示,经典校准的 SC 测量值低估了 cSBP。涉及所有三种设备的侵入性研究将更具启发性。