Automated pulse wave velocity assessment using a professional oscillometric office blood pressure monitor

Abstract

Stiffness of the large arteries is closely associated with aging and hypertension and is an independent predictor of cardiovascular morbidity and mortality. 1-5 Carotid-femoral pulse wave velocity (cfPWV) is the gold standard for measuring large artery stiffness 1 and several studies have established the additive value of cfPWV in terms of risk stratification. 5,6 The European Society of Cardiology/European Society of Hypertension has endorsed cfPWV for assessing hypertension-mediated organ damage. 1 However, wide use of cfPWV measurement is impractical due to considerable technological and methodological heterogeneity in its assessment and other issues related to device cost, observer time, and experience, patient inconvenience in femoral pulse acquisition, etc, and thus, it is not recommended for routine use. 1 In the last years, there is accumulating evidence regarding the automated measurement of brachial-ankle pulse wave velocity

Associations of Brachial-Ankle Pulse Wave Velocity With Left Ventricular Geometry and Diastolic Function in Untreated Hypertensive Patients

“…Regarding the capability of HMODs assessment, a study from northern Shanghai reported that cfPWV may be more closely related to the creatinine clearance and carotid artery intimal-media thickness compared to the baPWV, but there was no significant difference observed for the association with cardiac damages between the two methods, including LV mass index or E/e' (11). Other studies also showed that the baPWV has significant associations with HMODs similar to the cfPWV (31,32), suggesting baPWV as an acceptable alternative to the cfPWV. Therefore, baPWV may hold promise as an initial screening test for better risk stratification in hypertensive patients.…”

Measuring arterial stiffness in clinical practice: Moving one step forward

“…Bringing the concept of arterial stiffness into clinical practice is a vital but challenging task. The study conducted by Kollias et al 20 represents an imperative step further by investigating the agreement between baPWV and cf PWV and their relationships with target organ indices. With a more convenient, reliable, and accurate measurement of arterial stiffness, the widespread clinical application of arterial stiffness concept can be expected consequently.…”

“…The study concluded that the automated baPWV measurement by a professional oscillometric blood pressure monitor is feasible and observer‐independent. The baPWV values were higher than cfPWV by 4.0 ± 1.4 m/s ( P < .01), yet they were closely correlated ( r = .70, P < .01), and had reasonable agreement in detecting increased arterial stiffness and carotid plaques 20 . Automatic and easy measurement of arterial stiffness with reasonably good accuracy could therefore be realized and help bridge the T2 gap.…”

“…It should be emphasized that cfPWV and baPWV are two different stiffness indices. With a modest correlation coefficient ( r = .7) presented in the study, 20 they represent the extent of stiffness over two different arterial trees but may be associated with the same ongoing systematic pathophysiology, such as aging, high BP, and diabetes. Nevertheless, both baPWV and cfPWV were associated with cardiovascular risk factors and indices of carotid stiffness and atherosclerosis and presented similar predictive value for the detection of carotid plaques, which demonstrates the clinical relevance of baPWV measurement in risk stratification 20 …”

“…However, before it can be used in health care, 14 its agreement with the gold standard has to be demonstrated (T1 gap). In this issue, Kollias et al investigated the agreement between automated baPWV taken by a professional oscillometric blood pressure monitor (Microlife WatchBP Office Vascular) versus the reference cfPWV (Complior device) 20 . The study concluded that the automated baPWV measurement by a professional oscillometric blood pressure monitor is feasible and observer‐independent.…”