Feasibility and reproducibility of noninvasive 24-h ambulatory aortic blood pressure monitoring with a brachial cuff-based oscillometric device.

BACKGROUND

Accumulating evidence suggests the potential superiority of office aortic blood pressure (BP) over brachial in the management of arterial hypertension. The noninvasive aortic 24-h ambulatory brachial BP monitoring (ABPM) is potentially the optimal method for assessing BP profile. The objective of the present study was to investigate the feasibility and reproducibility to perform noninvasively 24-h aortic ABPM with a novel validated brachial cuff-based automatic oscillometric device (Mobilo-O-Graph) which records brachial BP and waveforms and assesses aortic BP via mathematical transformation.

METHODS

Thirty consecutive subjects (mean age: 53.6 ± 11.6 years, 17 men) had a test-retest ABPM with at least 1-week interval. No modification of vasoactive drug treatment during the interval was allowed while similar 24-h activity during both recording days was recommended.

RESULTS

The average number of valid readings for brachial vs. aortic BP were 69.9 ± 10.4 vs. 58.0 ± 13.3 in the initial 24-h assessment (P < 0.001) and 68.3 ± 10.8 vs. 56.4 ± 13.6 in the repeat assessment (P < 0.001). No differences in average 24 h aortic BP values were observed between the two assessments (systolic blood pressure (SBP) 115.9 ± 7.7 vs. 115.1 ± 6.0 mm Hg, respectively, P = 0.48, and diastolic 79.7 ± 7.4 vs. 79.2 ± 8.7, P = 0.54). Reproducibility indices of aortic pressure including, intraclass coefficient of variation (SBP: 0.80 (95% confidence interval 0.58-0.90); diastolic: 0.92 (0.83-0.96)) and s.d. of differences (SBP/diastolic: 6.0/4.5 mm Hg) indicated acceptable reproducibility. The Bland-Altman plots indicated no evidence of systemic bias.

CONCLUSIONS

In conclusion, these data suggest that noninvasive 24-h ABPM is feasible and provides reproducible values. Future studies should validate the prognostic ability of 24-h aortic hemodynamics.