eprintid: 10121838 rev_number: 20 eprint_status: archive userid: 608 dir: disk0/10/12/18/38 datestamp: 2021-02-17 09:29:32 lastmod: 2021-11-30 23:20:40 status_changed: 2021-02-17 09:29:32 type: article metadata_visibility: show creators_name: Picone, DS creators_name: Schultz, MG creators_name: Armstrong, MK creators_name: Black, JA creators_name: Bos, WJW creators_name: Chen, C-H creators_name: Cheng, H-M creators_name: Cremer, A creators_name: Dwyer, N creators_name: Hughes, AD creators_name: Kim, H-L creators_name: Lacy, PS creators_name: Laugesen, E creators_name: Liang, F creators_name: Ohte, N creators_name: Okada, S creators_name: Omboni, S creators_name: Ott, C creators_name: Pereira, T creators_name: Pucci, G creators_name: Schmieder, RE creators_name: Sinha, MD creators_name: Stouffer, GA creators_name: Takazawa, K creators_name: Roberts-Thomson, P creators_name: Wang, J-G creators_name: Weber, T creators_name: Westerhof, BE creators_name: Williams, B creators_name: Sharman, JE creators_name: Invasive Blood Pressure Consortium, title: Identifying Isolated Systolic Hypertension From Upper-Arm Cuff Blood Pressure Compared With Invasive Measurements ispublished: pub divisions: UCL divisions: B02 divisions: D14 divisions: GA3 keywords: aorta, blood pressure, coronary angiography, hypertension, prevalence note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Isolated systolic hypertension (ISH) is the most common form of hypertension and is highly prevalent in older people. We recently showed differences between upper-arm cuff and invasive blood pressure (BP) become greater with increasing age, which could influence correct identification of ISH. This study sought to determine the difference between identification of ISH by cuff BP compared with invasive BP. Cuff BP and invasive aortic BP were measured in 1695 subjects (median 64 years, interquartile range [55-72], 68% male) from the INSPECT (Invasive Blood Pressure Consortium) database. Data were recorded during coronary angiography among 29 studies, using 21 different cuff BP devices. ISH was defined as ≥130/<80 mm Hg using cuff BP compared with invasive aortic BP as the reference. The prevalence of ISH was 24% (n=407) according to cuff BP but 38% (n=642) according to invasive aortic BP. There was fair agreement (Cohen κ, 0.36) and 72% concordance between cuff and invasive aortic BP for identifying ISH. Among the 28% of subjects (n=471) with misclassification of ISH status by cuff BP, 20% (n=96) of the difference was due to lower cuff systolic BP compared with invasive aortic systolic BP (mean, -16.4 mm Hg [95% CI, -18.7 to -14.1]), whereas 49% (n=231) was from higher cuff diastolic BP compared with invasive aortic diastolic BP (+14.2 mm Hg [95% CI, 11.5-16.9]). In conclusion, compared with invasive BP, cuff BP fails to identify ISH in a sizeable portion of older people and demonstrates the need to improve cuff BP measurements. date: 2021-02 date_type: published official_url: https://doi.org/10.1161/HYPERTENSIONAHA.120.16109 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1840797 doi: 10.1161/HYPERTENSIONAHA.120.16109 lyricists_name: Hughes, Alun lyricists_name: Lacy, Peter lyricists_name: Williams, Bryan lyricists_id: ADHUG42 lyricists_id: PSLAC83 lyricists_id: BWILL10 actors_name: Lacy, Peter actors_id: PSLAC83 actors_role: owner full_text_status: public publication: Hypertension volume: 77 number: 2 pagerange: 632-639 event_location: United States issn: 1524-4563 citation: Picone, DS; Schultz, MG; Armstrong, MK; Black, JA; Bos, WJW; Chen, C-H; Cheng, H-M; ... Invasive Blood Pressure Consortium; + view all <#> Picone, DS; Schultz, MG; Armstrong, MK; Black, JA; Bos, WJW; Chen, C-H; Cheng, H-M; Cremer, A; Dwyer, N; Hughes, AD; Kim, H-L; Lacy, PS; Laugesen, E; Liang, F; Ohte, N; Okada, S; Omboni, S; Ott, C; Pereira, T; Pucci, G; Schmieder, RE; Sinha, MD; Stouffer, GA; Takazawa, K; Roberts-Thomson, P; Wang, J-G; Weber, T; Westerhof, BE; Williams, B; Sharman, JE; Invasive Blood Pressure Consortium; - view fewer <#> (2021) Identifying Isolated Systolic Hypertension From Upper-Arm Cuff Blood Pressure Compared With Invasive Measurements. Hypertension , 77 (2) pp. 632-639. 10.1161/HYPERTENSIONAHA.120.16109 <https://doi.org/10.1161/HYPERTENSIONAHA.120.16109>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10121838/1/389546_0_merged_1596633119.pdf