Diagnostic performance of a stand-alone central blood pressure monitor: application of central blood pressure in the diagnosis of high blood pressure

Hao-Min Cheng, Shih-Hsien Sung, Shao-Yuan Chuang, Alan Pearson, Catalin Tufanaru, Sarahlouise White, Wen-Chung Yu, Chen-Huan Chen

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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 3093 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) 9195), specificity of 95% (95% CI 9497), PPV of 96% (95% CI 9497), and NPV of 93% (95% CI 9095). 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 4453), 94% (95% CI 9296), 90% (95% CI 8693), and 63% (95% CI 5966), 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.

LanguageEnglish
Pages382-391
Number of pages10
JournalAmerican Journal of Hypertension
Volume27
Issue number3
DOIs
Publication statusPublished - Mar 2014
Externally publishedYes

Keywords

  • blood pressure
  • central blood pressure
  • diagnostic accuracy
  • hypertension
  • Microlife WatchBP Office Central
  • oscillometric signals
  • pulse volume plethysmography
  • sensitivity and specificity
  • sphygmomanometer

Cite this

Cheng, Hao-Min ; Sung, Shih-Hsien ; Chuang, Shao-Yuan ; Pearson, Alan ; Tufanaru, Catalin ; White, Sarahlouise ; Yu, Wen-Chung ; Chen, Chen-Huan. / Diagnostic performance of a stand-alone central blood pressure monitor : application of central blood pressure in the diagnosis of high blood pressure. In: American Journal of Hypertension. 2014 ; Vol. 27, No. 3. pp. 382-391.
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title = "Diagnostic performance of a stand-alone central blood pressure monitor: application of central blood pressure in the diagnosis of high blood pressure",
abstract = "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 3093 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) 9195), specificity of 95{\%} (95{\%} CI 9497), PPV of 96{\%} (95{\%} CI 9497), and NPV of 93{\%} (95{\%} CI 9095). 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 4453), 94{\%} (95{\%} CI 9296), 90{\%} (95{\%} CI 8693), and 63{\%} (95{\%} CI 5966), 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.",
keywords = "blood pressure, central blood pressure, diagnostic accuracy, hypertension, Microlife WatchBP Office Central, oscillometric signals, pulse volume plethysmography, sensitivity and specificity, sphygmomanometer",
author = "Hao-Min Cheng and Shih-Hsien Sung and Shao-Yuan Chuang and Alan Pearson and Catalin Tufanaru and Sarahlouise White and Wen-Chung Yu and Chen-Huan Chen",
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Diagnostic performance of a stand-alone central blood pressure monitor : application of central blood pressure in the diagnosis of high blood pressure. / Cheng, Hao-Min; Sung, Shih-Hsien; Chuang, Shao-Yuan; Pearson, Alan; Tufanaru, Catalin; White, Sarahlouise; Yu, Wen-Chung; Chen, Chen-Huan.

In: American Journal of Hypertension, Vol. 27, No. 3, 03.2014, p. 382-391.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Diagnostic performance of a stand-alone central blood pressure monitor

T2 - American Journal of Hypertension

AU - Cheng, Hao-Min

AU - Sung, Shih-Hsien

AU - Chuang, Shao-Yuan

AU - Pearson, Alan

AU - Tufanaru, Catalin

AU - White, Sarahlouise

AU - Yu, Wen-Chung

AU - Chen, Chen-Huan

PY - 2014/3

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N2 - 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 3093 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) 9195), specificity of 95% (95% CI 9497), PPV of 96% (95% CI 9497), and NPV of 93% (95% CI 9095). 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 4453), 94% (95% CI 9296), 90% (95% CI 8693), and 63% (95% CI 5966), 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.

AB - 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 3093 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) 9195), specificity of 95% (95% CI 9497), PPV of 96% (95% CI 9497), and NPV of 93% (95% CI 9095). 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 4453), 94% (95% CI 9296), 90% (95% CI 8693), and 63% (95% CI 5966), 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.

KW - blood pressure

KW - central blood pressure

KW - diagnostic accuracy

KW - hypertension

KW - Microlife WatchBP Office Central

KW - oscillometric signals

KW - pulse volume plethysmography

KW - sensitivity and specificity

KW - sphygmomanometer

U2 - 10.1093/ajh/hpt282

DO - 10.1093/ajh/hpt282

M3 - Article

VL - 27

SP - 382

EP - 391

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 3

ER -