Cuff-Based Oscillometric Measurements of Central Hemodynamics: Factors Influencing Central Augmentation Pressure in Normotensive Japanese Individuals

Abstract

Background: Recently, new devices using oscillometric cuff have been developed to derive central blood pressure (BP) waveform from brachial BP waveform. Late systolic pressure augmentation of central BP waveform is a marker of central hemodynamics. Mobil-O-Graph, a cuff-based oscillometric device, can assess central augmentation pressure (AP) together with central BP. Central AP measurement using the Mobil-O-Graph in the European population was reported to be associated with age and sex. However, factors influencing central AP in the Asian population have not been shown. Objectives and Methods: We enrolled 110 normotensive volunteers (50 men; age range, 21‒76 years). Central BP and AP were measured using the Mobil-O-Graph on the left arm with the subjects in the seated position after resting for at least 5 min. We compared central hemodynamics between the sexes. We investigated factors influencing central AP in uni- and multivariate linear regression analyses and age-related change in central AP using the Mobil-O-Graph in healthy Japanese individuals. Results: Central AP were lower in men than in women (5.5 ± 2.8 vs. 11.0 ± 4.7 mm Hg, p < 0.001). The central AP in the total cohort was positively correlated with age (r = 0.325, p < 0.001) and inversely correlated with height (r = −0.601, p < 0.001) in the Pearson correlations. In multivariate regression analysis, the parameters influencing central AP (R² = 0.467) were age (β = 0.097, p < 0.001), sex (β = −2.890, p = 0.010), and height (β = −0.153, p = 0.031). The central AP (10.0 ± 4.8 mm Hg) in the ≥50-year-old group significantly increased compared with those in the 20- to 39-year-old group (6.7 ± 4.2 mm Hg, p < 0.05). Conclusions: Age, sex, and height influenced central AP, as assessed using the Mobil-O-Graph. Age-related increase in central AP was observed in normotensive Japanese individuals. Brachial cuff-based waveform recordings using the Mobil-O-Graph are feasible for the estimation of central AP in the Asian population.

Relation between Oscillometric Measurement of Central Hemodynamics and Left Ventricular Hypertrophy in Hypertensive Patients

“…With respect to AIx measurement, the Mobil-O-Graph reportedly showed a low agreement with Arteriograph ( r = 0.007, p = 0.924) and Complior ( r = 0.135, p = 0.05) in a previous study [12]. In that study, the average AIx measured by the Mobil-O-Graph in 211 individuals (age, 55.1 ± 14.1 years; 67.8% men; 50.2% hypertensive patients) was 17.8 ± 11.3%, which seemed lower than that in our study (32.7 ± 13.4%) but similar to that formerly reported in another study on normotensive men (16.8 ± 7.3%) [15]. Another study on subjects who were almost the same age (53.9 ± 7.9 years) as those in the aforementioned study with a normal cardiac-ankle vascular index score (no probable atherosclerosis) showed that the average AIx measured by the Mobil-O-Graph was 23.76 ± 14.49% [23].…”

“…In this study on hypertensive patients, the AP in men and women was 11.2 ± 6.2 mm Hg and 17.3 ± 8.1 mm Hg, respectively. In our previous study on normotensive individuals, the AP in men and women was 5.5 ± 2.8 mm Hg and 11.0 ± 4.7 mm Hg, respectively [15]. The AP in both sexes in this study was expected to be higher than that in normotensive men.…”

“…After the echocardiographic measurements, we performed oscillometric measurements of the central hemodynamics using the Mobil-O-Graph. Pulse-wave analysis was performed as described previously [15]. Briefly, the measurements were obtained in a quiet and temperature-controlled (22–25°C) room in a seated position.…”

“…The AIx measured by the SphygmoCor showed a high correlation ( r = 0.822, p < 0.001) with the radial AIx of the radial artery measured by applanation tonometry [21]. Therefore, the AIx measured using the Mobil-O-Graph was validated against the tonometric measurements of the radial AIx (HEM-9000AI; Omron Healthcare Co., Ltd., Kyoto, Japan) in 110 normotensive healthy individuals (age range, 21–76 years; 50 men) [15]. The results showed that the AIx measured by the Mobil-O-Graph did not present negative AIx values but moderately correlated with the radial AIx measurements by the HEM-9000AI ( r = 0.602, p < 0.001) (Fig.…”

“…Our previous study showed that the brachial cuff-based waveform recordings using the Mobil-O-Graph are feasible for the estimation of central AP in normotensive Japanese individuals [15]. Few studies have evaluated the correlation between the central SBP or AIx measured using the Mobil-O-Graph and LVH [16].…”