4.
H
ypertension
M
anagement
S
oftware Client-Server
65
Mobil-O-Graph
®
, operating instructions, Rev. 5.1 10/2015, GmbH
4
Preparing the Mobil-O-Graph ® with integrated 24h-PWA with
protocol 11
starts a regular blood pressure
measurement at the preset intervals. After measuring blood pressure, a PWA is carried out as well, by re-infla-
ting the device and recording the pulse at the diastolic pressure.
The 24h-PWA measurement identifies patients suspected of having LVH (left ventricular hypertrophy) and cor-
relates with the actual physiological aortic systolic blood pressure. Initial scientific evidence shows that predic-
tions regarding mortality are significantly better suited if the
MAP-C2-calibration
is used.
4.14.5 Reading and Analysing the 24h-PWA
Reading and analysing is carried out like a regular 24h-ABPM.
See chapter 4.9 “Reading Measured Values and Measuring Device” and 4.11.12 ”24h-PWA”.
4.14.6 Display of Pulse Wave Analysis
After a successfully carried out PWA measurement the following analysis appears
Out of 10 measured pulse waves, one filtered, average pulse wave is determined and the central aortal pulse
wave is calculated with it.
The augmentation index (AIx) is always cited in the literature in dependence of sex, age and heart rate. For
this reason a standardized display in accordance with these conditions is often used. First the augmentati-
on index is standardized using an empiric determined regression [1] to 75 heart beats. This parameter is then
described as Alx@75. If you analyse a representative cross-section of the population, as for example descri-
bed in [2], you shall receive an age-dependent estimate for the Alx@75 plus the respective confidence inter-
val. These relevant analyses have also shown that there is a significant difference for the average Alx@75 bet-
ween men and women.
Based on research with a surveyed cross-section of the population of about 2,000 people, in the following figure
average values and 90% confidence interval were determined. As with the already discussed analysis, an incre-
ase of the Alx until the 55th year can also be identified in the self-surveyed measurements. Afterwards, a plateau
building up for both sexes follows. The level difference of the Alx between the sexes is about 8 to 10%. If the
measured values exceed the sex- and age-specific interval, further examinations according to the European exa-
mination guidelines for hypertension [3] are recommended in order to detect the reason for the dysfunction.
Figure 4.1: Average value and 90% confidence interval for the Alx@75
4.14.5