Moving On—On Average in the Right Direction?

Weber, Thomas; Wassertheurer, Siegfried

doi:10.1161/hypertensionaha.113.02885

Cited by 16 publications

(5 citation statements)

References 12 publications

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“…20,23,25,26,28 The brachial blood pressure, used in daily practice, underestimate real invasive brachial pressure. The same holds true for all devices that are 37 Estimation methods have been improved, devices now calibrate their central pressures estimation using mean and diastolic pressure instead of systolic brachial blood pressure, since these appear to be constant, whereas systolic pressure varies along the arterial tree. Since in our study the same method was used before and after treatment, the same errors occurred at the two measurements.…”

Section: Discussionmentioning

confidence: 89%

“…Parameters obtained by pressure wave analysis were central pressures (systolic, diastolic, and mean), augmentation index corrected for a heart rate of 75 beats per minute (AIx@HR75), and SEVR. The built-in algorithms (validated in multiple studies as summarized by Weber et al 37 were used to derive these parameters.…”

Section: Non-invasive Methodsmentioning

confidence: 99%

“…The common approaches are applanation tonometry at the radial and carotid artery or an oscillometric method based on brachial cuff measurements. Reproducibility and validity of applanation tonometry for non-invasive central blood pressure estimation have been extensively investigated, as summarized by Weber et al 37 Validation studies for oscillometric devices are more limited and generally report a lower accuracy than radial applanation tonometry, with a recent example of a brachial cuff device not meeting the accuracy criteria of central BP assessment. 29 In this study applanation tonometry at the radial artery was therefore selected as non-invasive measurement method.…”

Section: Introductionmentioning

confidence: 99%

“…EVAR endovascular aneurysm repair, IQR interquartile range, @HR 75 corrected for a heart rate of 75 beats per minute; P denotes the difference between the invasive and non-invasive method; * denotes significantly different from pre-EVAR measurement (p < .05).currently available for estimating central blood pressure. reproducibility and validity of the different devices, available for non-invasive central blood pressure estimation, have been extensively investigated, as summarized byWeber et al in 2014. …”

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confidence: 99%

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Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair

Holewijn

Vermeulen

Helvert

et al. 2021

Cardiovasc Eng Tech

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Purpose-The aim of this study was to investigate if noninvasive central pressure estimations are accurate in patients with an abdominal aortic aneurysm, before and after endovascular repair. Secondary evaluation was if measurement-accuracy was dependent on anatomical characteristics. Methods-Procedural invasive and non-invasive pressuremeasurements were performed simultaneously both before and after endovascular repair in 20 patients with an infrarenal abdominal aortic aneurysm. Invasive catheter measurements were performed in the abdominal aorta. A tonometric device was used to perform non-invasive pressure-wave-analysis at the radial artery. A generalized transfer-function was used to generate an ascending aortic waveform for both measurements, allowing for direct comparison.Results-Pre-treatment the mean differences between methods were À 5.5 mmHg (p = .904), À 11.8 (p < .001), and À 7.2 mmHg (p = .124) for central systolic, diastolic, and mean pressure, respectively. The accuracy was dependent of aneurysm sac volume and intraluminal thrombus volume. Post-treatment limits of agreement were smaller for all pressure parameters compared to pre-treatment. The mean differences were 6.5 mmHg (p = .007), À 6.4 (p < .020), and 1.6 mmHg (p = .370) for central systolic, diastolic, and mean pressure, respectively. Conclusion-In untreated AAA's the accuracy of non-invasive central pressure estimation was acceptable (mean difference between 5 and 10 mmHg) when compared to invasive pressures, but dependent of AAA characteristics. After EVAR the accuracy of central pressure estimation improved (reduction of 75% of the mean difference between pre and post measurements) Trial Registration Number-NCT03469388; 3-5-2018.

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Section: Discussionmentioning

confidence: 89%

Section: Non-invasive Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair

Holewijn

Vermeulen

Helvert

et al. 2021

Cardiovasc Eng Tech

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“…The method was entitled “N-point moving average” (NPMA) ( 47 ). Because of its filtering characteristics, the NPMA method provides aoSBP levels and enables one to obtain aoPP, but in contrast to other methods, no information about aoBP waveforms is given ( 48 ). NPMA was initially proposed as a simple method to estimate aoSBP from RA-derived BP ( 47 ).…”

Section: Methodsmentioning

confidence: 99%

Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement

Zócalo,

Bia,

Sánchez

et al. 2023

Front. Cardiovasc. Med.

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BackgroundSystolic blood pressure amplification (SBPA) and pulse pressure amplification (PPA) can independently predict cardiovascular damage and mortality. A wide range of methods are used for the non-invasive estimation of SBPA and PPA. The most accurate non-invasive method for obtaining SBPA and/or PPA remains unknown.AimThis study aims to evaluate the agreement between the SBPA and PPA values that are invasively and non-invasively obtained using different (1) measurement sites (radial, brachial, carotid), (2) measuring techniques (tonometry, oscillometry/plethysmography, ultrasound), (3) pulse waveform analysis approaches, and (4) calibration methods [systo-diastolic vs. approaches using brachial diastolic and mean blood pressure (BP)], with the latter calculated using different equations or measured by oscillometry.MethodsInvasive aortic and brachial pressure (catheterism) and non-invasive aortic and peripheral (brachial, radial) BP were simultaneously obtained from 34 subjects using different methodologies, analysis methods, measuring sites, and calibration methods. SBPA and PPA were quantified. Concordance correlation and the Bland–Altman analysis were performed.Results(1) In general, SBPA and PPA levels obtained with non-invasive approaches were not associated with those recorded invasively. (2) The different non-invasive approaches led to (extremely) dissimilar results. In general, non-invasive measurements underestimated SBPA and PPA; the higher the invasive SBPA (or PPA), the greater the underestimation. (3) None of the calibration schemes, which considered non-invasive brachial BP to estimate SBPA or PPA, were better than the others. (4) SBPA and PPA levels obtained from radial artery waveform analysis (tonometry) (5) and common carotid artery ultrasound recordings and brachial artery waveform analysis, respectively, minimized the mean errors.ConclusionsOverall, the findings showed that (i) SBPA and PPA indices are not “synonymous” and (ii) non-invasive approaches would fail to accurately determine invasive SBPA or PPA levels, regardless of the recording site, analysis, and calibration methods. Non-invasive measurements generally underestimated SBPA and PPA, and the higher the invasive SBPA or PPA, the higher the underestimation. There was not a calibration scheme better than the others. Consequently, our study emphasizes the strong need to be critical of measurement techniques, to have methodological transparency, and to have expert consensus for non-invasive assessment of SBPA and PPA.

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Österreichischer Blutdruckkonsens 2019

Weber

Arbeiter

Ardelt

et al. 2019

Wien Klin Wochenschr

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ZusammenfassungErhöhter Blutdruck bleibt eine Hauptursache von kardiovaskulären Erkrankungen, Behinderung und frühzeitiger Sterblichkeit in Österreich, wobei die Raten an Diagnose, Behandlung und Kontrolle auch in rezenten Studien suboptimal sind. Das Management von Bluthochdruck ist eine häufige Herausforderung für Ärztinnen und Ärzte vieler Fachrichtungen. In einem Versuch, diagnostische und therapeutische Strategien zu standardisieren und letztendlich die Rate an gut kontrollierten Hypertoniker/innen zu erhöhen und dadurch kardiovaskuläre Erkrankungen zu verhindern, haben 13 österreichische medizinische Fachgesellschaften die vorhandene Evidenz zur Prävention, Diagnose, Abklärung, Therapie und Konsequenzen erhöhten Blutdrucks gesichtet. Das hier vorgestellte Ergebnis ist der erste Österreichische Blutdruckkonsens. Die Autoren und die beteiligten Fachgesellschaften sind davon überzeugt, daß es einer gemeinsamen nationalen Anstrengung bedarf, die Blutdruck-assoziierte Morbidität und Mortalität in unserem Land zu verringern.

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Moving On—On Average in the Right Direction?

Cited by 16 publications

References 12 publications

Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair

Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair

Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement

Österreichischer Blutdruckkonsens 2019

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