Reference values of office central blood pressure, pulse wave velocity, and augmentation index recorded by means of the Mobil-O-Graph PWA monitor.

Assessment of central blood pressure (BP), pulse wave velocity (PWV), and augmentation index (AIx) measurements may improve cardiovascular risk stratification. This study aimed to establish reference office values for central BP, PWV, and AIx by means of a Mobil-O-Graph PWA monitor and to evaluate the impact of cardiovascular risk factors (CVRFs) on these measurements. We cross-sectionally evaluated clinical characteristics, central BP, PWV, AIx, and peripheral BP measurements among 867 apparently healthy individuals (age = 46.0 ± 15.5 years, 39% males) who were free of obesity, hypertension, active smoking, dyslipidemia, and diabetes (CVRF-No) and 5632 individuals (age = 57.0 ± 14.7 years, 44% males) with at least one of these major CVRFs (CVRF-Yes). Reference values for central BP, PWV, and AIx were provided for the CVRF-No and CVRF-Yes groups, stratified by age and sex. PWV and AIx exhibited curvilinear increases with age, and there was an interaction between age and sex for central systolic BP and PWV in both the CVRF-No and CVRF-Yes groups. The results of a multivariable analysis including the whole sample (n = 6499) showed that obesity had a direct association with central BP, while diabetes was directly related to PWV. In addition, alcohol intake was directly associated with central BP, while performance of physical activity was inversely related to AIx. In conclusion, values of office-measured central BP, PWV, and AIx obtained in an apparently healthy population and in a population with CVRFs are now available according to age and sex and may be useful to build thresholds for use in clinical practice.

Evaluation of transit time-based models in wearable central aortic blood pressure estimation.

Evidence suggests that central aortic blood pressure (CABP) may provide a more accurate prognosis of cardiovascular events than peripheral pressure. The capability of monitoring CABP in a continuous, wearable, unobtrusive way might have a significant impact on hypertension management. The purpose of this study is to experimentally explore whether a wearable device equipped with an electrocardiogram (ECG) and ballistocardiogram (BCG) acquisition system could be used to predict CABP. This is based on state-of-the-art results on the relationship between transit time extracted from these signals and CABP. Ten young, healthy volunteers participated in the study where data-sets were acquired during three hemodynamic interventions, i.e., breath-holding, Valsalva maneuver, and cold pressor. Each data-set included ECG and BCG waveforms acquired by the wearable device and a CABP assessment from a cuff-based device. A total of nine PTT-based models (PBMs) derived from pulse transit time methodology were considered. Each PBM was tested with three alternative feature times extracted from the recorded waveforms PBMs were calibrated with data-sets acquired at baseline state, which were not considered for testing the PBM estimation performance. Four of the nine tested models presented a proper agreement in estimating CABP through the acquired signals, after the calibration procedure with baseline-state data. Results in one of these promising models are the following. Mean estimation error (95% confidence interval), systolic: 0 to 1.7 mmHg, diastolic: 0.4 to 2.3 mmHg, Pearson correlation: 0.82 systolic and 0.78 diastolic (p < 0.001). The proposed methodology may lead to continuous wearable BP monitoring.