Validation of Oscillometric Pulse Wave Analysis Measurements in Children

BACKGROUND Pulse wave analysis (PWA) has emerged as a noninvasive, valid, reliable, and widely used technique to investigate central blood pressures and systemic arterial wave reflection (augmentation index). The goldstandard technique is tonometry, but this technique can be challenging, especially when used on children. The purpose of this study was to validate oscillometric PWA for use in children. METHODS Fifty-seven healthy children were recruited for participation. Central blood pressures and peripheral augmentation index (pAIx) were measured objectively using oscillometric (Pulsecor R7) and tonometric (SphygmaCor) devices. All measurements were made during the same visit under standardized conditions between the hours of 8 am and 10 am in the fasted state. RESULTS Tonometric measurements were unsuccessful on 1 child. Comparisons were made on 56 children ( mean age = 9.8 +/- 1.0 y; 57% male). A very strong relationship was found between devices for central systolic ( r = 0.94; P < 0.001), diastolic ( r = 0.99; P < 0.001) and mean ( r = 0.96; P < 0.001) blood pressures. However, Bland-Altman analysis indicated a bias toward greater systolic blood pressures with the oscillometric monitor ( mean difference = 4.5 mm Hg; 95% confidence interval (CI) = -5.16 to -3.89). A good relationship was found for pAIx ( r=0.71; p < 0.001); the mean difference between devices was -1.70% ( 95% CI = 4.47% to 1.08%), which is not significantly different from zero. CONCLUSIONS Findings from this study suggest that oscillometric PWA provides valid measures of central blood pressure and arterial wave reflection in children aged 8-10 years.