Department of Population Health, Division of Epidemiology, NYU Langone Health, New York, USA.
Division of Epidemiology, NYC Department of Health and Mental Hygiene, New York, USA.
J Urban Health. 2019 Oct;96(5):720-725. doi: 10.1007/s11524-019-00385-x.
New York City Health and Nutrition Examination Survey (NYC HANES) was a population-based cross-sectional survey of NYC adults conducted twice, in 2004 and again in 2013-2014, to monitor the health of NYC adults 20 years or older. While blood pressure was measured in both surveys, an auscultatory mercury sphygmomanometer was used to measure blood pressure in clinics in 2004, and an oscillometric LifeSource UA-789AC monitor was used in homes in 2013-2014. To assess comparability of blood pressure results across both surveys, we undertook a randomized study comparing blood pressure (BP) readings by the two devices. Blood pressure measuring protocols followed the 2013 Association for the Advancement in Medical instrumentation guidelines for non-invasive blood pressure device. Data from 167 volunteers were analyzed for this purpose.Paired t tests were used to test for significant difference in mean systolic and diastolic blood pressure between devices for overall and by mid-arm circumference categories. To test for systematic differences between the two devices, we generated Bland-Altman graphs. Sensitivity, specificity, and Kappa statistics were calculated to assess between-device agreement for high (≥ 130/80 mmHg) and not high (< 130/80 mmHg) blood pressure, with mercury set as the reference.Systolic and diastolic blood pressure measured by LifeSource UA-789AC were on average 2.0 and 1.1 mmHg higher, respectively, than those of the mercury sphygmomanometer systolic and diastolic blood pressure readings (P < 0.05). Sensitivity was 81%, specificity was 96%, and the Kappa coefficient was 75%. The Bland-Altman graphs showed that the between-device difference did not vary as a function of the average of the two devices for systolic blood pressure and was larger in the lower and upper ends for diastolic blood pressure. Given the observed differences in systolic and diastolic blood pressure readings between the two blood pressure measurement approaches, we calibrated NYC HANES 2013-2014 blood pressure data by predicting mercury blood pressure values from LifeSource blood pressure values. The mean systolic and diastolic blood pressure in NYC HANES 2013-2014 were lower when data were calibrated.
纽约市健康与营养调查（NYC HANES）是一项针对纽约市成年人的基于人群的横断面调查，于 2004 年和 2013-2014 年进行了两次，以监测 20 岁及以上纽约市成年人的健康状况。虽然两次调查都测量了血压，但 2004 年在诊所使用听诊式水银血压计测量血压，2013-2014 年在家庭中使用示波法 LifeSource UA-789AC 监测仪测量血压。为了评估两次调查中血压结果的可比性，我们进行了一项随机研究，比较了两种设备的血压读数。血压测量方案遵循了 2013 年医疗器械促进协会（AAMI）用于无创血压设备的指南。为此目的分析了 167 名志愿者的数据。使用配对 t 检验测试了两种设备之间总体和中臂周长分类的收缩压和舒张压的平均差异是否具有统计学意义。为了测试两种设备之间是否存在系统差异，我们生成了 Bland-Altman 图。计算了敏感性、特异性和 Kappa 统计量，以评估水银作为参考时，两种设备对高（≥130/80mmHg）和不高（<130/80mmHg）血压的一致性。LifeSource UA-789AC 测量的收缩压和舒张压平均比水银血压计高 2.0 和 1.1mmHg（P<0.05）。敏感性为 81%，特异性为 96%，Kappa 系数为 75%。Bland-Altman 图显示，两种设备之间的差异并不随两种设备的平均值而变化，收缩压的差异较大，舒张压的差异在上下限处较大。鉴于两种血压测量方法之间的收缩压和舒张压读数存在差异，我们通过从 LifeSource 血压值预测水银血压值来校准 NYC HANES 2013-2014 年的血压数据。校准后，NYC HANES 2013-2014 年的平均收缩压和舒张压较低。
