Impact of Methodological and Calibration Approach on the Association of Central and Peripheral Systolic Blood Pressure with Cardiac Structure and Function in Children, Adolescents and Adults

Abstract

Introduction: Peripheral and aortic systolic blood pressure (pSBP and aoSBP) were measured using different methodological and calibration approaches to analyze the association and agreement between pSBP and/or aoSBP, and the association of pSBP and aoSBP with left ventricle (LV) and atrium (LA) structural–functional characteristics. Methods: In healthy subjects (n = 269, age: 9–85 years; n = 147, age < 24 years) LV and LA parameters were echocardiography-derived. pSBP and aoSBP were obtained by brachial sub-diastolic (Mobil-O-Graph®) and supra-systolic oscillometry (Arteriograph®) and aortic diameter waveform re-calibration (RCD; ultrasonography), using three calibration schemes: systo-diastolic (SD), calculated mean (CM), and oscillometric mean (OscM). Results: Always pSBP and aoSBP were positively associated; aoSBP obtained with the Mobil-O-Graph® and calibrated to CM or OscM were the ones that showed the lowest levels of association with the remaining forms of aoSBP and pSBP. Bland-Altman related mean errors varied noticeably (e.g. − 27, − 23, − 17, − 12 or 8 mmHg when aoSBP obtained with MOG (OscM) was compared with data from other methodological and calibration schemes). The aoSBP data obtained with Mobil-O-Graph® (calibration: CM and OscM) showed the highest levels of association with cardiac structural characteristics. aoSBP values obtained calibrating to OscM were higher than those obtained calibrating to SD or CM. Conclusions: aoSBP obtained with Mobil-O-Graph® and calibrated to CM or OscM showed (1) lower association with other forms of aoSBP and pSBP determination and (2) higher levels of association with LV and LA structural characteristics. Differences in aoSBP data between approaches were more sensitive to the calibration method than to the device used.