Accuracy of the WatchBP Office Central as a Type 2 device for non-invasive estimation of central aortic blood pressure in children and adolescents

• Published in: Journal of human hypertension 2024-12, Vol.38 (12), p.814-820
• Main Authors: Glenning, Jonathan P., Sandhu, Kieran, Harrington, Hilary A., Eastaugh, Lucas, Lane, Geoffrey K., Smolich, Joseph J., Mynard, Jonathan P.
• Format: Article
• Language: English
• Subjects: 692/699/75/243; 692/700/139; 692/700/459/1748; Adolescent; Adolescents; Age determination; Aorta; Aorta - diagnostic imaging; Aorta - physiology; Arterial Pressure; Blood pressure; Blood Pressure Determination - instrumentation; Blood Pressure Determination - methods; Cardiovascular diseases; Child; Child, Preschool; Children; Children & youth; Decision making; Epidemiology; Female; Health Administration; Humans; Hypertension; Hypertension - diagnosis; Hypertension - physiopathology; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Predictive Value of Tests; Public Health; Reproducibility of Results; Teenagers
• ISSN: 1476-5527; 0950-9240; 1476-5527
• DOI: 10.1038/s41371-024-00956-9

High blood pressure (BP) in childhood is a recognised precursor of elevated cardiovascular risk in adulthood. Brachial BP is normally used for clinical decision making, but central BP may be a better marker of pressure load on the heart. There is a paucity of validated non-invasive, automated devices for estimating central BP in children and adolescents. In this study, we compared the WatchBP Office Central (a Type 2 central pressure estimation device) against a high-fidelity micromanometer in the ascending aorta of anaesthetised patients undergoing clinically-indicated catheterisation ( n  = 15, age 4–16 years). As a secondary aim, central systolic BP (cSBP) was also compared to two non-invasive estimation methods in 34 awake patients undergoing routine cardiac MRI (age 10–18 years). WatchBP substantially overestimated cSBP compared to the intra-arterial gold-standard reference (26.1 ± 7.4 mmHg), and recruitment was terminated at n  = 11 (included in the analysis) due to high statistical certainty that the device would not pass the validation criteria of 5±8 mmHg. WatchBP cSBP was also substantially higher than values obtained from a phase contrast MRI method (11.8 ± 7.9 mmHg) and the SphygmoCor XCEL (13.5 ± 8.9 mmHg) in the awake patient group, which translate to 21–23 mmHg on average after accounting for known/estimated biases in these non-invasive comparators. Compared with invasive central diastolic and systolic BPs, the brachial measures from WatchBP yielded errors of 0.1 ± 5.6 and 12.5 ± 6.0 mmHg respectively. We conclude that the WatchBP substantially overestimates cSBP in children and adolescents. These findings reinforce the need for central BP-measuring devices to be further developed and validated in this population.