A complex pattern of agreement between oscillometric and tonometric measurement of arterial stiffness in a population-based sample

作者：Gunjaca Grgo; Jeroncic Ana; Budimir Danijela; Mudnic Ivana; Kolcic Ivana; Polasek Ozren; Rudan Igor; Boban Mladen^*

来源：Journal of Hypertension, 2012, 30(7): 1444-1452.

DOI：10.1097/HJH.0b013e3283546532

• arterial stiffness
• Arteriograph
• augmentation index
• central SBP
• general population
• SphygmoCor

Objective: Arterial stiffness can be estimated by several noninvasive methods. In a large population-based sample we performed an agreement analysis of the set of arterial stiffness indices (ASIs) measured by tonometric (SphygmoCor) and oscillometric (Arteriograph) techniques.
Methods: Central augmentation index (cAlx) and peripheral augmentation index (pAlx), as well as central SBP (cSBP) were measured in 1012 participants from a population-based study. Data were analyzed using Bland Altman agreement analysis, multivariate adaptive regression splines and Fisher's linear discriminant analysis.
Results: In contrast to high initial correlation between two devices (r=0.87 for pAlx, 0.88 for cAlx and 0.95 for cSBP), plotting against each other the values of measured AS's revealed their uneven distribution and grouping into three distinctive clusters of participants. The strongest cluster discriminators were age and DBP (cluster 1: age <40, DBP 70.42 +/- 7.41; cluster 2: age >40, DBP 77.36 +/- 10.16; cluster 3: age >60, DBP 82.56 +/- 9.48). Bland Altman analysis of clusters showed complex differences in agreement pattern for cAlx and pAlx. For cAlx SphygmoCor gives lower readings, especially in cluster 1, whereas for pAlx Arteriograph gives lower readings in cluster 1 and higher readings in clusters 2 and 3. The agreement for pAlx was better in younger participants and the same for cAlx in older participants.
Conclusion: ASIs obtained by SphygmoCor and Arteriograph cannot be interchangeably used as they seem to be differently influenced by predictors of arterial stiffness, predominantly by age. Different pattern of pAlx and cAlx agreement across clusters demonstrates importance of distinguishing cAlx and pAlx. Homogeneity of the study population for age should be considered when interpreting results of the studies investigating ASI.

• 出版日期2012-7