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Takayoshi Ohkubo - One of the best experts on this subject based on the ideXlab platform.
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introversion associated with large differences between screening Blood Pressure and home Blood Pressure measurement the ohasama study
2006Co-Authors: Atsushi Hozawa, Takayoshi Ohkubo, Masahiro Kikuya, Taku Obara, Hirohito Metoki, Kei Asayama, Kazuhito Totsune, Junichiro Hashimoto, Haruhisa Hoshi, Yumiko AraiAbstract:Objective To explore the effect of personality on screening Blood Pressures measured in clinical settings and home Blood Pressure measurements. Methods From 1997 to 1999, 699 participants underwent screening and home Blood Pressure measurements and completed the Japanese version of the short-form Eysenck personality questionnaire. An increased screening Blood Pressure was defined as screening Blood Pressure > or = 140/90 mmHg and an increased home Blood Pressure was defined as home Blood Pressure > or = 135/85 mmHg. Results Participants with lower extroversion scores (i.e., introversion) showed a greater difference between screening and home systolic Blood Pressure. The association between introversion and differences was statistically significant, even after adjustment for other possible factors (younger age, female, wide screening pulse Pressure, never smoked, and no antihypertensive medication). The adjusted means of SBP differences were 7.3 and 4.4 mmHg among the lowest and highest extroversion quartiles, respectively (P for trend = 0.02). Other personality scores (psychoticism or neuroticism) were not associated with screening and home Blood Pressure differences. The incorporation of an extroversion score in the basic model consisting of the above factors that affected the difference between screening and home Blood Pressure slightly improved the prediction of a high home Blood Pressure. The area under the receiver operating characteristic curve increased by 0.037 among participants with high screening Blood Pressure and 0.006 for those with normal screening Blood Pressure compared with the basic model. Conclusion Physicians may need to be aware of 'introverted' patients who have high Blood Pressure in clinic settings, because they have the potential for 'white-coat' hypertension.
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prognostic significance of the nocturnal decline in Blood Pressure in individuals with and without high 24 h Blood Pressure the ohasama study
2002Co-Authors: Takayoshi Ohkubo, Masahiro Kikuya, Atsushi Hozawa, Junichiro Hashimoto, Haruhisa Hoshi, Junko Yamaguchi, Kaori Ohmori, Mari Michimata, Mitsunobu Matsubara, Tsutomu ArakiAbstract:Objective To examine the relationship between the normal nocturnal decline in Blood Pressure and the risk of cardiovascular mortality in individuals with and without high 24-h Blood Pressure values.Methods We obtained 24-h ambulatory Blood Pressure readings from 1542 residents of Ohasama, Japan, who
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prediction of stroke by ambulatory Blood Pressure monitoring versus screening Blood Pressure measurements in a general population the ohasama study
2000Co-Authors: Takayoshi Ohkubo, Ichiro Tsuji, Kenichi Nagai, Masahiro Kikuya, Atsushi Hozawa, Sadayoshi Ito, H Satoh, Shigeru Hisamichi, Yutaka ImaiAbstract:Objective To investigate the association between 24 h, daytime and night-time ambulatory Blood Pressures and first symptomatic stroke, to compare their predictive powers for stroke with that of casual (screening) Blood Pressure, and to compare the predictive power for stroke between daytime and night-time Blood Pressures, in a general population in Ohasama, Japan. Design A prospective cohort study. Subjects and methods We obtained ambulatory Blood Pressure on 1464 subjects aged ≥ 40 years without history of symptomatic stroke, then followed-up their stroke-free survival. There were 74 first symptomatic stroke during the follow-up period (mean = 6.4 years). The prognostic significance of Blood Pressure for stroke risk was examined by a Cox proportional hazards regression model adjusted for possible confounding factors. Results The non-parametric and parametric analysis indicated that 24-h, daytime and night-time ambulatory Blood Pressures were linearly related with stroke risk. The likelihood ratio analysis demonstrated that these ambulatory Blood Pressures were significantly better related to stroke risk than did screening Blood Pressure, and that daytime Blood Pressure better predicted stroke risk than did night-time Blood Pressure. Conclusions The present study which prospectively investigated the relation between ambulatory Blood Pressure and first symptomatic stroke risk in a general population demonstrated that (i) ambulatory Blood Pressure values were linearly related to stroke risk; (ii) ambulatory Blood Pressures had the stronger predictive power for stroke risk than did screening Blood Pressure; and (iii) daytime Blood Pressure better related to stroke risk than did night-time Blood Pressure.
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home Blood Pressure measurement has a stronger predictive power for mortality than does screening Blood Pressure measurement a population based observation in ohasama japan
1998Co-Authors: Takayoshi Ohkubo, Yutaka Imai, Ichiro Tsuji, Kenichi Nagai, Junko Kato, Noriko Kikuchi, Akimitsu Nishiyama, Akiko Aihara, Makoto Sekino, Masahiro KikuyaAbstract:Objective To compare the predictive powers of self-measurement of Blood Pressure at home (home Blood Pressure measurement) and casual (screening) Blood Pressure measurement for mortality. Design A prospective cohort study. Subjects and methods We obtained home and screening Blood Pressure measurements for 1789 subjects aged ≥ 40 years who were followed up for a mean of 6.6 years. The prognostic significance of Blood Pressure for mortality was determined by the Cox proportional hazards regression model adjusted for age, sex, smoking status, past history of cardiovascular disease, and the use of antihypertensive medication. Results When the home Blood Pressure values and the screening Blood Pressure values were simultaneously incorporated into the Cox model as continuous variables, only the average of multiple (taken more than three times) home systolic Blood Pressure values was significantly and strongly related to the cardiovascular mortality risk. The average of the two initial home Blood Pressure values was also better related to the mortality risk than were the screening Blood Pressure values. Conclusions Home Blood Pressure measurement had a stronger predictive power for mortality than did screening Blood Pressure measurement for a general population. This appears to be the first study in which the prognostic significances of home and screening Blood Pressure measurements have been compared.
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prediction of mortality by ambulatory Blood Pressure monitoring versus screening Blood Pressure measurements a pilot study in ohasama
1997Co-Authors: Takayoshi Ohkubo, Yutaka Imai, Ichiro Tsuji, Kenichi Nagai, Noriko Watanabe, Naoyoshi Minami, Osamu Itoh, Takehiko Bando, Mariko Sakuma, Akira FukaoAbstract:Objective To compare the prediction of mortality by ambulatory Blood Pressure monitoring and screening Blood Pressure measurements in a general population. Design A prospective cohort study. Patients and methods We obtained Blood Pressure data for 1542 subjects (565 men and 977 women) aged ≥ 40 years who were followed up for up to 8.1 years (mean 5.1 years). Subjects were subdivided into five groups according to their ambulatory and screening Blood Pressure levels. The prognostic significance of Blood Pressure for mortality was examined by the Cox proportional hazards regression model. Results The association between Blood Pressure level and mortality was more distinctive for the ambulatory Blood Pressure than it was for the screening Blood Pressure. The risk of cardiovascular mortality increased significantly for the highest quintiles of 24 h ambulatory Blood Pressure, whereas there was no significant association between the screening Blood Pressure and the cardiovascular mortality. When both 24 h and screening Blood Pressure values were included in the Cox model, only the systolic ambulatory Blood Pressure was related significantly to the increased risk of cardiovascular mortality. Conclusions The ambulatory Blood Pressure had a stronger predictive power for mortality than did the screening Blood Pressure. This appears to have been the first study of the prognostic significance of ambulatory Blood Pressure monitoring versus screening Blood Pressure measurements in a general population.
Hao Min Cheng - One of the best experts on this subject based on the ideXlab platform.
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comparison of two generalized transfer functions for measuring central systolic Blood Pressure by an oscillometric Blood Pressure monitor
2013Co-Authors: Yuanta Shih, Hao Min Cheng, Shihhsien Sung, C H ChenAbstract:Comparison of two generalized transfer functions for measuring central systolic Blood Pressure by an oscillometric Blood Pressure monitor
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estimation of central systolic Blood Pressure using an oscillometric Blood Pressure monitor
2010Co-Authors: Hao Min Cheng, Kangling Wang, Yinghwa Chen, Shingjong Lin, Lungching ChenAbstract:Current noninvasive techniques for assessing central aortic Pressure require the recording of an arterial Pressure wave using a high-fidelity applanation tonometer. We therefore developed and validated a novel method to estimate the central aortic systolic Pressure using an oscillometric Blood Pressure monitor alone. Invasive high-fidelity right brachial and central aortic Pressure waves, and left-brachial pulse volume plethysmography from an oscillometric Blood Pressure monitor, were obtained at baseline and 3 min after administration of sublingual nitroglycerin in 100 patients during cardiac catheterization. In the initial 50 patients (Generation Group), Central systolic Blood Pressure was predicted by a multi-variate prediction model generated from the comprehensive analysis of the invasive brachial Pressure wave, including brachial late-systolic shoulder Pressure value and parameters related to wave reflection and arterial compliance. Another prediction model was similarly constructed from the noninvasively calibrated pulse volume plethysmography. Both models were validated in the subsequent 50 patients (Validation Group) with results: r=0.98 (P<0.001) and mean difference=0.5+/-4.5 (95% confidence interval -8.3 to 9.3) mm Hg for the invasive model, and r=0.93 (P<0.001) and mean difference=-0.1+/-7.6 (95% confidence interval -15.0 to 14.8) mm Hg for the noninvasive model. Thus, our results indicate that central aortic systolic Blood Pressure could be estimated by analysis of the noninvasive brachial Pressure wave alone from an oscillometric Blood Pressure monitor.
Yutaka Imai - One of the best experts on this subject based on the ideXlab platform.
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task force ii Blood Pressure measurement and cardiovacular outcome
2001Co-Authors: Jan A. Staessen, Gianfranco Parati, Yutaka Imai, Roland Asmar, Marc De Buyzere, Kazayuki Shimada, George S Stergiou, Josep Redon, Paolo VerdecchiaAbstract:To reach a consensus on the prognostic significance of new techniques of automated Blood Pressure measurement. A Task Force on the prognostic significance of ambulatory Blood Pressure monitoring wrote this review in preparation for the Eighth International Consensus Conference (28–31 October 2001, Sendai, Japan). This synopsis was amended to account for opinions aired at the conference and to reflect the common ground reached in the discussions. (1) Prospective studies in treated and untreated hypertensive patients and in the general population have demonstrated that, even after adjusting for established risk factors, the incidence of cardiovascular events is correlated with Blood Pressure on conventional as well as ambulatory measurement. Ambulatory monitoring, however, significantly refines the prediction already provided by conventional Blood Pressure measurement. (2) White-coat hypertension is usually defined as an elevated clinic Blood Pressure in the presence of a normal daytime ambulatory Blood Pressure. Event-based studies in hypertensive patients have convincingly demonstrated that the risk of cardiovascular disease is less in patients with white-coat hypertension than in those with higher ambulatory Blood Pressure levels even after controlling for concomitant risk factors. Based on prognostic evidence, white-coat hypertension can now be defined as a conventional Blood Pressure that is persistently equal to or greater than 140/90 mmHg with an average daytime ambulatory Blood Pressure of below 135/85 mmHg. The issue of whether or not white-coat hypertension predisposes to sustained hypertension needs further research. (3) There is a growing body of evidence showing that a decreased nocturnal fall in Blood Pressure (<10% of the daytime level) is associated with a worse prognosis, irrespective of whether night-time dipping is studied as a continuous or a class variable. (4) Intermittent techniques of ambulatory Blood Pressure monitoring are limited in terms of quantifying short-term Blood Pressure variability. Proven cardiovascular risk factors such as old age, a higher than usual Blood Pressure and diabetes mellitus are often associated with greater short-term Blood Pressure variability. After adjusting for these risk factors, some − but not all − studies have nevertheless reported an independent and positive relationship between cardiovascular outcome and measures of variability of daytime and night-time Blood Pressure, for example standard deviation. (5) Reference values for ambulatory Blood Pressure measurement in children are currently based on statistical parameters of Blood Pressure distribution. In children and adolescents, functional rather than distribution-based definitions of ambulatory hypertension have yet to be developed. (6) Several studies of gestational hypertension have shown that, compared with office measurement, ambulatory Blood Pressure monitoring is a better predictor of maternal and fetal complications. Pregnancy is a special indication for ambulatory monitoring so that the white-coat effect can be measured and pregnant women are not given antihypertensive drugs unnecessarily. (7) Ambulatory pulse Pressure and the QKD interval are measurements obtained by ambulatory monitoring that to some extent reflect the functional characteristics of the large arteries. The QKD interval is correlated with left ventricular mass, and ambulatory pulse Pressure is a strong predictor of cardiovascular outcome. (8) Under standardized conditions, the self-measurement of Blood Pressure is equally as effective as ambulatory Blood Pressure monitoring in identifying the white-coat effect, but further studies are required to elucidate fully the prognostic accuracy of self-measured Blood Pressure in comparison with conventional and ambulatory Blood Pressure measurement. Ambulatory Blood Pressure measurement refines the prognostic information provided by conventional Blood Pressure readings obtained in the clinic or the doctor's office. Longitudinal studies of patients with white-coat hypertension should clarify the transient, persistent or progressive nature of this condition, particularly in paediatric patients, in whom white-coat hypertension may be a harbinger of sustained hypertension and target-organ damage in adulthood. Finally, the applicability, cost-effectiveness and long-term prognostic accuracy of the self-measurement of Blood Pressure should be evaluated in relation to conventional Blood Pressure measurement and ambulatory monitoring.
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prediction of stroke by ambulatory Blood Pressure monitoring versus screening Blood Pressure measurements in a general population the ohasama study
2000Co-Authors: Takayoshi Ohkubo, Ichiro Tsuji, Kenichi Nagai, Masahiro Kikuya, Atsushi Hozawa, Sadayoshi Ito, H Satoh, Shigeru Hisamichi, Yutaka ImaiAbstract:Objective To investigate the association between 24 h, daytime and night-time ambulatory Blood Pressures and first symptomatic stroke, to compare their predictive powers for stroke with that of casual (screening) Blood Pressure, and to compare the predictive power for stroke between daytime and night-time Blood Pressures, in a general population in Ohasama, Japan. Design A prospective cohort study. Subjects and methods We obtained ambulatory Blood Pressure on 1464 subjects aged ≥ 40 years without history of symptomatic stroke, then followed-up their stroke-free survival. There were 74 first symptomatic stroke during the follow-up period (mean = 6.4 years). The prognostic significance of Blood Pressure for stroke risk was examined by a Cox proportional hazards regression model adjusted for possible confounding factors. Results The non-parametric and parametric analysis indicated that 24-h, daytime and night-time ambulatory Blood Pressures were linearly related with stroke risk. The likelihood ratio analysis demonstrated that these ambulatory Blood Pressures were significantly better related to stroke risk than did screening Blood Pressure, and that daytime Blood Pressure better predicted stroke risk than did night-time Blood Pressure. Conclusions The present study which prospectively investigated the relation between ambulatory Blood Pressure and first symptomatic stroke risk in a general population demonstrated that (i) ambulatory Blood Pressure values were linearly related to stroke risk; (ii) ambulatory Blood Pressures had the stronger predictive power for stroke risk than did screening Blood Pressure; and (iii) daytime Blood Pressure better related to stroke risk than did night-time Blood Pressure.
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home Blood Pressure measurement has a stronger predictive power for mortality than does screening Blood Pressure measurement a population based observation in ohasama japan
1998Co-Authors: Takayoshi Ohkubo, Yutaka Imai, Ichiro Tsuji, Kenichi Nagai, Junko Kato, Noriko Kikuchi, Akimitsu Nishiyama, Akiko Aihara, Makoto Sekino, Masahiro KikuyaAbstract:Objective To compare the predictive powers of self-measurement of Blood Pressure at home (home Blood Pressure measurement) and casual (screening) Blood Pressure measurement for mortality. Design A prospective cohort study. Subjects and methods We obtained home and screening Blood Pressure measurements for 1789 subjects aged ≥ 40 years who were followed up for a mean of 6.6 years. The prognostic significance of Blood Pressure for mortality was determined by the Cox proportional hazards regression model adjusted for age, sex, smoking status, past history of cardiovascular disease, and the use of antihypertensive medication. Results When the home Blood Pressure values and the screening Blood Pressure values were simultaneously incorporated into the Cox model as continuous variables, only the average of multiple (taken more than three times) home systolic Blood Pressure values was significantly and strongly related to the cardiovascular mortality risk. The average of the two initial home Blood Pressure values was also better related to the mortality risk than were the screening Blood Pressure values. Conclusions Home Blood Pressure measurement had a stronger predictive power for mortality than did screening Blood Pressure measurement for a general population. This appears to be the first study in which the prognostic significances of home and screening Blood Pressure measurements have been compared.
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prediction of mortality by ambulatory Blood Pressure monitoring versus screening Blood Pressure measurements a pilot study in ohasama
1997Co-Authors: Takayoshi Ohkubo, Yutaka Imai, Ichiro Tsuji, Kenichi Nagai, Noriko Watanabe, Naoyoshi Minami, Osamu Itoh, Takehiko Bando, Mariko Sakuma, Akira FukaoAbstract:Objective To compare the prediction of mortality by ambulatory Blood Pressure monitoring and screening Blood Pressure measurements in a general population. Design A prospective cohort study. Patients and methods We obtained Blood Pressure data for 1542 subjects (565 men and 977 women) aged ≥ 40 years who were followed up for up to 8.1 years (mean 5.1 years). Subjects were subdivided into five groups according to their ambulatory and screening Blood Pressure levels. The prognostic significance of Blood Pressure for mortality was examined by the Cox proportional hazards regression model. Results The association between Blood Pressure level and mortality was more distinctive for the ambulatory Blood Pressure than it was for the screening Blood Pressure. The risk of cardiovascular mortality increased significantly for the highest quintiles of 24 h ambulatory Blood Pressure, whereas there was no significant association between the screening Blood Pressure and the cardiovascular mortality. When both 24 h and screening Blood Pressure values were included in the Cox model, only the systolic ambulatory Blood Pressure was related significantly to the increased risk of cardiovascular mortality. Conclusions The ambulatory Blood Pressure had a stronger predictive power for mortality than did the screening Blood Pressure. This appears to have been the first study of the prognostic significance of ambulatory Blood Pressure monitoring versus screening Blood Pressure measurements in a general population.
Masahiro Kikuya - One of the best experts on this subject based on the ideXlab platform.
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short term Blood Pressure variability in relation to outcome in the international database of ambulatory Blood Pressure in relation to cardiovascular outcome idaco
2011Co-Authors: Masahiro Kikuya, Katarzyna Stolarzskrzypek, Lutgarde Thijs, Tine W Hansen, Jose Boggia, Tatiana Kuznetsova, Gladys E Maestre, Luis J MenaAbstract:Ambulatory Blood Pressure monitoring not only provides information on the Blood Pressure level, but on the diurnal changes in Blood Pressure as well. The present review summarizes the main fi nding...
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introversion associated with large differences between screening Blood Pressure and home Blood Pressure measurement the ohasama study
2006Co-Authors: Atsushi Hozawa, Takayoshi Ohkubo, Masahiro Kikuya, Taku Obara, Hirohito Metoki, Kei Asayama, Kazuhito Totsune, Junichiro Hashimoto, Haruhisa Hoshi, Yumiko AraiAbstract:Objective To explore the effect of personality on screening Blood Pressures measured in clinical settings and home Blood Pressure measurements. Methods From 1997 to 1999, 699 participants underwent screening and home Blood Pressure measurements and completed the Japanese version of the short-form Eysenck personality questionnaire. An increased screening Blood Pressure was defined as screening Blood Pressure > or = 140/90 mmHg and an increased home Blood Pressure was defined as home Blood Pressure > or = 135/85 mmHg. Results Participants with lower extroversion scores (i.e., introversion) showed a greater difference between screening and home systolic Blood Pressure. The association between introversion and differences was statistically significant, even after adjustment for other possible factors (younger age, female, wide screening pulse Pressure, never smoked, and no antihypertensive medication). The adjusted means of SBP differences were 7.3 and 4.4 mmHg among the lowest and highest extroversion quartiles, respectively (P for trend = 0.02). Other personality scores (psychoticism or neuroticism) were not associated with screening and home Blood Pressure differences. The incorporation of an extroversion score in the basic model consisting of the above factors that affected the difference between screening and home Blood Pressure slightly improved the prediction of a high home Blood Pressure. The area under the receiver operating characteristic curve increased by 0.037 among participants with high screening Blood Pressure and 0.006 for those with normal screening Blood Pressure compared with the basic model. Conclusion Physicians may need to be aware of 'introverted' patients who have high Blood Pressure in clinic settings, because they have the potential for 'white-coat' hypertension.
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prognostic significance of the nocturnal decline in Blood Pressure in individuals with and without high 24 h Blood Pressure the ohasama study
2002Co-Authors: Takayoshi Ohkubo, Masahiro Kikuya, Atsushi Hozawa, Junichiro Hashimoto, Haruhisa Hoshi, Junko Yamaguchi, Kaori Ohmori, Mari Michimata, Mitsunobu Matsubara, Tsutomu ArakiAbstract:Objective To examine the relationship between the normal nocturnal decline in Blood Pressure and the risk of cardiovascular mortality in individuals with and without high 24-h Blood Pressure values.Methods We obtained 24-h ambulatory Blood Pressure readings from 1542 residents of Ohasama, Japan, who
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prediction of stroke by ambulatory Blood Pressure monitoring versus screening Blood Pressure measurements in a general population the ohasama study
2000Co-Authors: Takayoshi Ohkubo, Ichiro Tsuji, Kenichi Nagai, Masahiro Kikuya, Atsushi Hozawa, Sadayoshi Ito, H Satoh, Shigeru Hisamichi, Yutaka ImaiAbstract:Objective To investigate the association between 24 h, daytime and night-time ambulatory Blood Pressures and first symptomatic stroke, to compare their predictive powers for stroke with that of casual (screening) Blood Pressure, and to compare the predictive power for stroke between daytime and night-time Blood Pressures, in a general population in Ohasama, Japan. Design A prospective cohort study. Subjects and methods We obtained ambulatory Blood Pressure on 1464 subjects aged ≥ 40 years without history of symptomatic stroke, then followed-up their stroke-free survival. There were 74 first symptomatic stroke during the follow-up period (mean = 6.4 years). The prognostic significance of Blood Pressure for stroke risk was examined by a Cox proportional hazards regression model adjusted for possible confounding factors. Results The non-parametric and parametric analysis indicated that 24-h, daytime and night-time ambulatory Blood Pressures were linearly related with stroke risk. The likelihood ratio analysis demonstrated that these ambulatory Blood Pressures were significantly better related to stroke risk than did screening Blood Pressure, and that daytime Blood Pressure better predicted stroke risk than did night-time Blood Pressure. Conclusions The present study which prospectively investigated the relation between ambulatory Blood Pressure and first symptomatic stroke risk in a general population demonstrated that (i) ambulatory Blood Pressure values were linearly related to stroke risk; (ii) ambulatory Blood Pressures had the stronger predictive power for stroke risk than did screening Blood Pressure; and (iii) daytime Blood Pressure better related to stroke risk than did night-time Blood Pressure.
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home Blood Pressure measurement has a stronger predictive power for mortality than does screening Blood Pressure measurement a population based observation in ohasama japan
1998Co-Authors: Takayoshi Ohkubo, Yutaka Imai, Ichiro Tsuji, Kenichi Nagai, Junko Kato, Noriko Kikuchi, Akimitsu Nishiyama, Akiko Aihara, Makoto Sekino, Masahiro KikuyaAbstract:Objective To compare the predictive powers of self-measurement of Blood Pressure at home (home Blood Pressure measurement) and casual (screening) Blood Pressure measurement for mortality. Design A prospective cohort study. Subjects and methods We obtained home and screening Blood Pressure measurements for 1789 subjects aged ≥ 40 years who were followed up for a mean of 6.6 years. The prognostic significance of Blood Pressure for mortality was determined by the Cox proportional hazards regression model adjusted for age, sex, smoking status, past history of cardiovascular disease, and the use of antihypertensive medication. Results When the home Blood Pressure values and the screening Blood Pressure values were simultaneously incorporated into the Cox model as continuous variables, only the average of multiple (taken more than three times) home systolic Blood Pressure values was significantly and strongly related to the cardiovascular mortality risk. The average of the two initial home Blood Pressure values was also better related to the mortality risk than were the screening Blood Pressure values. Conclusions Home Blood Pressure measurement had a stronger predictive power for mortality than did screening Blood Pressure measurement for a general population. This appears to be the first study in which the prognostic significances of home and screening Blood Pressure measurements have been compared.
Lungching Chen - One of the best experts on this subject based on the ideXlab platform.
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estimation of central systolic Blood Pressure using an oscillometric Blood Pressure monitor
2010Co-Authors: Hao Min Cheng, Kangling Wang, Yinghwa Chen, Shingjong Lin, Lungching ChenAbstract:Current noninvasive techniques for assessing central aortic Pressure require the recording of an arterial Pressure wave using a high-fidelity applanation tonometer. We therefore developed and validated a novel method to estimate the central aortic systolic Pressure using an oscillometric Blood Pressure monitor alone. Invasive high-fidelity right brachial and central aortic Pressure waves, and left-brachial pulse volume plethysmography from an oscillometric Blood Pressure monitor, were obtained at baseline and 3 min after administration of sublingual nitroglycerin in 100 patients during cardiac catheterization. In the initial 50 patients (Generation Group), Central systolic Blood Pressure was predicted by a multi-variate prediction model generated from the comprehensive analysis of the invasive brachial Pressure wave, including brachial late-systolic shoulder Pressure value and parameters related to wave reflection and arterial compliance. Another prediction model was similarly constructed from the noninvasively calibrated pulse volume plethysmography. Both models were validated in the subsequent 50 patients (Validation Group) with results: r=0.98 (P<0.001) and mean difference=0.5+/-4.5 (95% confidence interval -8.3 to 9.3) mm Hg for the invasive model, and r=0.93 (P<0.001) and mean difference=-0.1+/-7.6 (95% confidence interval -15.0 to 14.8) mm Hg for the noninvasive model. Thus, our results indicate that central aortic systolic Blood Pressure could be estimated by analysis of the noninvasive brachial Pressure wave alone from an oscillometric Blood Pressure monitor.
