Diagnostic Performance of a Stand-Alone Central Blood Pressure Monitor: Application of Central Blood Pressure in the Diagnosis of High Blood Pressure

BACKGROUND Oscillometric central blood pressure (CBP) monitors have emerged as a new technology for blood pressure (BP) measurements. With a newly proposed diagnostic threshold for CBP, we investigated the diagnostic performance of a novel CBP monitor. METHODS We recruited a consecutive series of 13...

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Bibliographic Details
Published in:	American journal of hypertension 2014-03, Vol.27 (3), p.382-391
Main Authors:	Cheng, Hao-Min, Sung, Shih-Hsien, Chuang, Shao-Yuan, Pearson, Alan, Tufanaru, Catalin, White, Sarahlouise, Yu, Wen-Chung, Chen, Chen-Huan
Format:	Article
Language:	eng
Subjects:	Adult Aged Aged, 80 and over Blood Pressure Blood Pressure Determination - instrumentation Blood Pressure Determination - standards Blood Pressure Monitors - standards Calibration Confidence intervals Equipment Design Female Humans Hypertension Hypertension - diagnosis Hypertension - physiopathology Male Middle Aged Oscillometry Predictive Value of Tests
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Summary:	BACKGROUND Oscillometric central blood pressure (CBP) monitors have emerged as a new technology for blood pressure (BP) measurements. With a newly proposed diagnostic threshold for CBP, we investigated the diagnostic performance of a novel CBP monitor. METHODS We recruited a consecutive series of 138 subjects (aged 30-93 years) without previous use of antihypertensive agents for simultaneous invasive and noninvasive measurements of BP in a catheterization laboratory. With the cutoff (CBP ≥130/90mm Hg) for high blood pressure (HBP), the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the novel CBP monitor were calculated with reference to the measured CBP. In comparison, the diagnostic performance of the conventional cuff BP was also evaluated. RESULTS The noninvasive CBP for detecting HBP in a sample with a prevalence of 52% showed a sensitivity of 93% (95% confidence interval (CI) = 91-95), specificity of 95% (95% CI = 94-97), PPV of 96% (95% CI = 94-97), and NPV of 93% (95% CI = 90-95). In contrast, with cuff BP and the traditional HBP criterion (cuff BP ≥140/90mm Hg), the sensitivity, specificity, PPV, and NPV were 49% (95% CI = 44-53), 94% (95% CI = 92-96), 90% (95% CI = 86-93), and 63% (95% CI 59-66), respectively. CONCLUSIONS A stand-alone oscillometric CBP monitor may provide CBP values with acceptable diagnostic accuracy. However, with reference to invasively measured CBP, cuff BP had low sensitivity and NPV, which could render possible management inaccessible to a considerable proportion of HBP patients, who may be identifiable through noninvasive CBP measurements from the CBP monitor.
ISSN:	0895-7061 1879-1905 1941-7225