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未治疗患者中心收缩压无创估计的方法学评估:博加卢萨心脏研究

Methodological evaluation of the noninvasive estimation of central systolic blood pressure in nontreated patients: the Bogalusa Heart Study.

作者信息

Fernandez Camilo, Hsu Robert, Sander Gary, Hussain Azad, Barshop Rupert, Li Shengxu, Shu Tian, Zhang Tao, Galazka Patrycja, Chen Wei, Bazzano Lydia, Giles Thomas D

机构信息

aDepartment of Epidemiology, Tulane University School of Public Health and Tropical Medicine bHeart and Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana cHeartGEN Institute dHeart and Vascular Center, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

出版信息

Blood Press Monit. 2017 Apr;22(2):95-100. doi: 10.1097/MBP.0000000000000224.

Abstract

OBJECTIVES

This study sought to compare the estimation of central systolic blood pressure (cSBP) obtained by two different noninvasive devices, in addition to its comparisons with measured peripheral systolic blood pressure (pSBP), in a biracial (Black/White) community-based cohort.

PARTICIPANTS AND METHODS

Estimations of cSBP by applanation tonometry were obtained in 586 participants of the Bogalusa Heart Study (mean age: 43.5 years; 69% White, 54% women) using two different commonly used instruments: Omron HEM-9000AI and SphygmoCor CPV. pSBP was measured using a standard auscultatory technique.

RESULTS

The estimation of cSBP by the Omron device was higher than that of the SphygmoCor device (124.2±17.1 vs. 111.4±15.2 mmHg, P<0.001). Moreover, cSBP by Omron was significantly higher than peripheral blood pressure (124.2±17.1 vs. 119.4±15.6 mmHg, P<0.001), whereas cSBP by SphygmoCor was significantly lower than pSBP (111.4±15.2 vs. 119.4±15.6 mmHg, P<0.001). Similar results were observed in race-specific and sex-specific analyses.

CONCLUSION

These findings support the hypothesis that notable differences exist in the estimation of cSBP provided by the instruments utilized in this study. Further standardization studies are required to establish the most appropriate noninvasive estimation of cSBP before this parameter may be considered in the assessment, prediction, and prevention of cardio-metabolic risk and overt cardiovascular disease in clinical practice.

摘要

目的

本研究旨在比较两种不同的非侵入性设备所测得的中心收缩压(cSBP)估值,并将其与测量得到的外周收缩压(pSBP)进行比较,研究对象为一个基于社区的双种族(黑人/白人)队列。

参与者与方法

在博加卢萨心脏研究的586名参与者(平均年龄:43.5岁;69%为白人,54%为女性)中,使用两种不同的常用仪器:欧姆龙HEM - 9000AI和SphygmoCor CPV,通过压平式眼压测量法获取cSBP估值。使用标准听诊技术测量pSBP。

结果

欧姆龙设备测得的cSBP估值高于SphygmoCor设备(124.2±17.1 vs. 111.4±15.2 mmHg,P<0.001)。此外,欧姆龙测得的cSBP显著高于外周血压(124.2±17.1 vs. 119.4±15.6 mmHg,P<0.001),而SphygmoCor测得的cSBP显著低于pSBP(111.4±15.2 vs. 119.4±15.6 mmHg,P<0.001)。在种族特异性和性别特异性分析中观察到类似结果。

结论

这些发现支持了这样一种假设,即本研究中使用的仪器在cSBP估值方面存在显著差异。在临床实践中考虑将该参数用于评估、预测和预防心脏代谢风险及显性心血管疾病之前,需要进一步开展标准化研究,以确定最合适的cSBP非侵入性估值方法。

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本文引用的文献

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Estimation of central aortic blood pressure: a systematic meta-analysis of available techniques.
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4
Women have significantly greater difference between central and peripheral arterial pressure compared with men: the Bogalusa Heart Study.
J Am Soc Hypertens. 2013 Sep-Oct;7(5):379-85. doi: 10.1016/j.jash.2013.05.007. Epub 2013 Jul 12.
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Central blood pressure in the management of hypertension: soon reaching the goal?
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