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Calibrating Local Population-Based Blood Pressure Data from NYC HANES 2013–2014

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Abstract

New York City Health and Nutrition Examination Survey (NYC HANES) was a population-based cross-sectional survey of NYC adults conducted twice, in 2004 and again in 2013–2014, to monitor the health of NYC adults 20 years or older. While blood pressure was measured in both surveys, an auscultatory mercury sphygmomanometer was used to measure blood pressure in clinics in 2004, and an oscillometric LifeSource UA-789AC monitor was used in homes in 2013–2014. To assess comparability of blood pressure results across both surveys, we undertook a randomized study comparing blood pressure (BP) readings by the two devices. Blood pressure measuring protocols followed the 2013 Association for the Advancement in Medical instrumentation guidelines for non-invasive blood pressure device. Data from 167 volunteers were analyzed for this purpose.

Paired t tests were used to test for significant difference in mean systolic and diastolic blood pressure between devices for overall and by mid-arm circumference categories. To test for systematic differences between the two devices, we generated Bland-Altman graphs. Sensitivity, specificity, and Kappa statistics were calculated to assess between-device agreement for high (≥ 130/80 mmHg) and not high (< 130/80 mmHg) blood pressure, with mercury set as the reference.

Systolic and diastolic blood pressure measured by LifeSource UA-789AC were on average 2.0 and 1.1 mmHg higher, respectively, than those of the mercury sphygmomanometer systolic and diastolic blood pressure readings (P < 0.05). Sensitivity was 81%, specificity was 96%, and the Kappa coefficient was 75%. The Bland-Altman graphs showed that the between-device difference did not vary as a function of the average of the two devices for systolic blood pressure and was larger in the lower and upper ends for diastolic blood pressure. Given the observed differences in systolic and diastolic blood pressure readings between the two blood pressure measurement approaches, we calibrated NYC HANES 2013–2014 blood pressure data by predicting mercury blood pressure values from LifeSource blood pressure values. The mean systolic and diastolic blood pressure in NYC HANES 2013–2014 were lower when data were calibrated.

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References

  1. Thorpe LE, Greene C, Freeman A, Snell E, Rodriguez-Lopez JS, Frankel M, et al. Rationale, design and respondent characteristics of the 2013-2014 New York City Health and Nutrition Examination Survey (NYC HANES 2013-2014). Prev Med Rep. 2015;2:580–5.

    Article  Google Scholar 

  2. Thorpe LE, Gwynn RC, Mandel-Ricci J, et al. Study design and participation rates of the New York City Health and Nutrition Examination Survey, 2004. Prev Chronic Dis. 2006;3(3):A94.

    PubMed  PubMed Central  Google Scholar 

  3. Czajka JL, Beyler A. Background paper - declining response rates in federal surveys: trends and implications. Mathematica Policy Research. 2016;1

  4. Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran D. Hypertension prevalence and control among adults: United States, 2015–2016. NCHS data brief, no 289. Hyattsville, MD. National Center for Health Statistics. 2017;

  5. Ostchega Y, Zhang G, Sorlie P, et al. Blood pressure randomized methodology study comparing automatic oscillometric and mercury sphygmomanometer devices: National Health and Nutrition Examination Survey, 2009-2010. National health statistics reports. 2012(59):1–15.

  6. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension (Dallas, Tex : 1979). 2018;71(6):1269–324.

    Article  CAS  Google Scholar 

  7. Center For Disease Control. National Health and Nutrition Examination Survey (NHANES) Anthropometry Procedures Manual. 2007.

  8. Ni H, Wu C, Prineas R, et al. Comparison of Dinamap PRO-100 and mercury sphygmomanometer blood pressure measurements in a population-based study. Am J Hypertens. 2006;19(4):353–60.

    Article  Google Scholar 

  9. Center For Disease Control. National Health and Nutrition Examination Survey. 2015-2016 data documentation, codebook, and frequencies. Blood Press. 2017; https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/BPX_I.htm. Accessed 22 Aug 2017.

  10. LifeSource. A&D Medical. Cuff size matters. http://lifesourcecanada.com/home_lifesource/cuff-size-matters/. Accessed 22 Aug 2017.

  11. Kanchi R, Perlman SE, Chernov C, Wu W, Tabaei BP, Trinh-Shevrin C, et al. Gender and race disparities in cardiovascular disease risk factors among New York City adults: New York City Health and Nutrition Examination Survey (NYC HANES) 2013-2014. Journal of urban health : bulletin of the New York Academy of Medicine. 2018;95(6):801–12.

    Article  Google Scholar 

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Acknowledgements

We thank all the study participants, study staff Rodrigo Arce, Stephanie Rettig, and Adeiyewunmi Osinubi, as well as the many DOHMH staff who made the study possible. We also thank Tatiana Nwankwo from Centers for Disease Control and Prevention for her expertise and help in training interviewers.

Funding

This project was co-funded by NYU Langone Health faculty discretionary fund and the NYC Department of Health and Mental Hygiene.

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Authors and Affiliations

  1. Department of Population Health, Division of Epidemiology, NYU Langone Health, New York, USA

    Rania Kanchi & Lorna E. Thorpe

  2. Division of Epidemiology, NYC Department of Health and Mental Hygiene, New York, USA

    Sharon Perlman & Claudia Chernov

  3. Center for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, USA

    Yechiam Ostchega

  4. Division of Prevention and Primary Care, NYC Department of Health and Mental Hygiene, New York, USA

    Shadi Chamany

  5. The Columbia Hypertension Center, Columbia University Medical Center, New York, USA

    Daichi Shimbo

Authors
  1. Rania Kanchi
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  2. Sharon Perlman
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  3. Yechiam Ostchega
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  4. Shadi Chamany
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  5. Daichi Shimbo
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  6. Claudia Chernov
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  7. Lorna E. Thorpe
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Corresponding author

Correspondence to Rania Kanchi.

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The study was approved by the institutional review boards of the NYC Department of Health and Mental Hygiene (DOHMH) and NYU School of Medicine.

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Kanchi, R., Perlman, S., Ostchega, Y. et al. Calibrating Local Population-Based Blood Pressure Data from NYC HANES 2013–2014. J Urban Health 96, 720–725 (2019). https://doi.org/10.1007/s11524-019-00385-x

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  • DOI: https://doi.org/10.1007/s11524-019-00385-x

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