A comparison among oscillometric waveforms in healthy nonpregnant women, pregnancy and hypertensive disorders of pregnancy.

IF 1.2 4区医学 Q4 PERIPHERAL VASCULAR DISEASE Blood Pressure Monitoring Pub Date : 2024-08-01 Epub Date: 2024-03-05 DOI:10.1097/MBP.0000000000000700

Jennifer S Ringrose, Sangita Sridar, Patricia Araneta, Lillian Chan, Jalisa Kassam, Mira Wirzba, Kate Greeff, Gillian Ramsay, Winnie Sia, Rshmi Khurana, Erin Bader, Raj Padwal

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Abstract

Objective: Understanding of how oscillometric waveforms (OMW) vary between pregnant and nonpregnant individuals remains low. An exploratory analysis was completed to assess for quantitative and qualitative changes in OMW and oscillometric envelope features in pregnancy.

Design and methods: Eighteen pregnant individuals (over 20 weeks gestational age) and healthy, nonpregnant (HNP) women were recruited. Six HNP were matched to six healthy pregnant (HP) women, and six pregnant women with a hypertensive disorder of pregnancy (HDP) by age, arm circumference, and cuff size. Blood pressure measurements were completed per the International Organization for Standardization (ISO) protocol using a custom-built oscillometric device as the test device and two-observer mercury auscultation as the reference measurement. Auscultatory blood pressure and blood pressure derived from slope-based and fixed ratio algorithms were determined. OMW and envelope features were compared among groups.

Results: In HNP, HP, and HDP groups respectively: mean auscultatory blood pressure (systolic mean ± SD/diastolic mean ± SD) was 103.4 ± 12.2/67.1 ± 7.9; 109.5 ± 3.1/58.1 ± 6.4; 135.6 ± 18.9/85.1 ± 14.2 mmHg. HDP had significantly higher auscultatory systolic and diastolic blood pressure than the HP group ( P = 0.001). The pregnant groups had a lower average pulse width (mean ± SD: HNP = 0.8 ± 0 s, HP = 0.6 ± 0.1 s, HDP = 0.6 ± 0.1 s; HP vs. HNP mean difference [adjusted P value]: 0.2 [ P = 0.004], HDP vs. HNP 0.1 [ P = 0.018]) compared with the HNP group. The HDP group had a larger area under the OMW envelope than the HNP group (mean ± SD: HNP = 22.6 ± 3.4; HDP = 28.5 ± 4.2; HDP vs. HNP mean difference [adjusted P value]: 5.9 P = 0.05).

Conclusion: In this exploratory work, differences in the OMW morphology and parameters were found in pregnancy and in hypertensive disorders of pregnancy compared with healthy controls. Even small differences may have important implications in algorithm development; further work comparing OMW envelopes in pregnancy is needed to optimize the algorithms used to determine blood pressure in pregnancy.

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健康非孕妇、孕妇和妊娠高血压患者的示波波形比较。

目的：人们对妊娠期和非妊娠期个体的振荡波形（OMW）如何变化的了解仍然较少。我们完成了一项探索性分析，以评估妊娠期 OMW 和示波包络特征的定量和定性变化：招募了 18 名孕妇（孕龄超过 20 周）和健康非孕妇（HNP）。根据年龄、臂围和袖带尺寸，将 6 名妊娠高血压患者与 6 名健康孕妇（HP）和 6 名妊娠高血压疾病孕妇（HDP）进行配对。血压测量按照国际标准化组织 (ISO) 的规程进行，使用定制的示波测量仪作为测试设备，使用双观察者水银听诊法作为参考测量方法。测定了听诊血压以及基于斜率算法和固定比率算法得出的血压。比较了各组的 OMW 和包膜特征：HNP、HP 和 HDP 组的平均听诊血压（收缩压平均值 ± SD/舒张压平均值 ± SD）分别为 103.4 ± 12.2/67.1 ± 7.9；109.5 ± 3.1/58.1 ± 6.4；135.6 ± 18.9/85.1 ± 14.2 mmHg。HDP 组的听诊收缩压和舒张压明显高于 HP 组（P = 0.001）。孕妇组的平均脉搏宽度较低（平均值±标准差：HNP = 0.8 ± 0 秒，HP = 0.6 ± 0.1 秒，HDP = 0.6 ± 0.1 秒；HP 与 HNP 的平均值差异[调整后 P 值]为 0.2 [P = 0.001]：0.2 [P = 0.004]，HDP vs. HNP 0.1 [P = 0.018]）。与 HNP 组相比，HDP 组的 OMW 包膜下面积更大（平均值 ± SD：HNP = 22.6 ± 3.4；HDP = 28.5 ± 4.2；HDP 与 HNP 的平均差异 [调整后 P 值]：5.9 [P = 0.05]）：5.9 P = 0.05）：在这项探索性研究中发现，与健康对照组相比，妊娠期和妊娠期高血压疾病患者的 OMW 形态和参数存在差异。即使是微小的差异也可能对算法的开发产生重要影响；需要进一步比较妊娠期的 OMW 包络线，以优化用于测定妊娠期血压的算法。

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来源期刊

Blood Pressure Monitoring 医学-外周血管病

CiteScore

2.00

自引率

7.70%

发文量

110

审稿时长

>12 weeks

期刊介绍： Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.