Comment
Author: Admin | 2025-04-28
Falsely lower the noninvasive BP in the affected arm. As such, the accuracy of all noninvasive BPs compared with the intra-arterial aortic BP was recalculated in the subgroup of participants with intra-arterial brachial BP measurements in which all individuals with significant interarm SBP differences (>5 mm Hg) were excluded. Other sensitivity analyses were performed to assess whether procedural factors could have influenced our results. As such, the accuracies of the brachial cuff BP compared with the invasive aortic BP according to sex were compared according to (1) the use of 5F or 6F catheters, (2) the administration of any vasoactive drugs within 5 minutes of the invasive BP measurements, (3) whether the primary study cardiologist (C.K.) performed the measurements, and (4) the signal quality of the automatic BP monitor. Finally, sensitivity analyses were performed to examine the association with other body size parameters by replacing weight with body mass index (calculated as weight in kilograms divided by height in meters squared) or body surface area (Du Bois formula26). The invasive BP study cohort consists of 500 participants (145 female [29%] and 355 male [71%]; 471 [94%] White; mean [SD] age, 66 [10] years) with invasive aortic BP recordings, of whom 303 had invasive brachial BP measurements without significant interarm BP difference (eFigure 1 in the Supplement). Women were shorter, weighed less, and had had less coronary artery disease than men but had similar age, body mass index, and comorbidities (Table 1). Both sexes had highly similar brachial cuff SBP (mean [SD], 124.4 [16.4] mm Hg in men and 124.5 [17.7] in women; P = .97), but women had lower brachial cuff DBP and thus higher brachial cuff pulse pressure. Table 2 gives comparisons of invasive aortic BP and noninvasive BPs between women and men. The invasive aortic SBP was significantly higher in women compared with men (mean [SD], 130.9 [21.7] vs 124.7 [20.1] mm Hg; difference, 6.2 mm Hg; P P > .99), but women had lower brachial cuff DBP values than men (mean [SD], 73.5 [10.7] vs 77.9 [10.5] mm Hg; P P = .04), whereas invasive brachial DBP did not differ between the sexes (eTable 1 in the Supplement). Invasive aortic to brachial SBP amplification was similar between women and men (mean [SD], 6.3 [10.3] vs 6.8 [9.1] mm Hg; P = .65). Accuracy of Noninvasive BP According to Sex In the overall cohort (irrespective of sex), the mean (SD) accuracies against the invasive aortic SBP were −2.1 (12.1) mm Hg for brachial cuff noninvasive central BP, −11.2 (13.6) mm Hg for type I noninvasive central BP, and 6.1 (14.9) mm Hg for type II noninvasive central BP. The brachial cuff was less accurate against invasive aortic SBP
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