Is Noninvasive Brachial Systolic Blood Pressure an Accurate Estimate of Central Aortic Systolic Blood Pressure?

Abstract

OBJECTIVES Noninvasive brachial systolic blood pressure (nSBP-B) usually approaches invasive central systolic blood pressure (iSBP-C) with a high correlation. Whether nSBP-B is an accurate estimate of iSBP-C remained to be investigated. Thus, this study aimed to compare the errors of nSBP-B and noninvasive central systolic blood pressure (nSBP-C) with different techniques in estimating iSBP-C. METHODS Simultaneous invasive high-fidelity central aortic pressure waveforms and the noninvasive left brachial pulse volume recording (PVR) waveform were recorded in a Generation group (N = 40) and a Validation group (N = 100). The accuracy of the noninvasive estimates of iSBP-C obtained from analysis of the calibrated PVR waveform using the generalized transfer function (GTF), pulse waveform analysis (PWA), and N-point moving average (NPMA) methods was examined in the Validation group by calculating the mean absolute error (MAE). RESULTS In Generation group, the MAE was 4.6±4.1mm Hg between nSBP-B and invasive brachial SBP, and 6.8±5.5mm Hg between nSBP-B and iSBP-C. In comparison, the MAE of between iSBP-C and nSBP-C with PWA, NPMA, and GTF were 5.5±4.5, 5.8±4.9, and 5.9±5.0mm Hg, respectively. In Validation group, the MAE of nSBP-B (6.9±4.6mm Hg) for estimating iSBP-C was significantly greater than that of PWA (5.0±3.4mm Hg) and NPMA (6.1±4.4mm Hg), and GTF (6.1±4.9mm Hg). The percentage of absolute band error ≤5mm Hg was 62% for nSBP-B, 69% for GTF, 83% for PWA, and 69% for NPMA. CONCLUSIONS The accuracy of nSBP-B was inferior to the n SBP-C measures in estimating iSBP-C.