02348nas a2200277 4500008004100000022001400041245005200055210005100107260001300158300001000171490000700181520163800188653000901826653001901835653003301854653001901887653001301906653001101919653002401930653001201954100001801966700001601984700001702000700001702017856003602034 1993 eng d a0194-911X00aProperties of the random zero sphygmomanometer.0 aProperties of the random zero sphygmomanometer c1993 May a632-70 v213 a

The random zero sphygmomanometer is widely used in studies involving blood pressure measurement because it is believed to eliminate digit preference and reduce measurement error. We performed blood pressure measurements sequentially using random zero and standard sphygmomanometers in random order in 1,356 participants in the Cardiovascular Health Study. Despite adherence to the manufacturer's instructions, we observed a substantially nonuniform distribution of zero levels generated by the random zero sphygmomanometer and a disturbing correlation between the zero level and blood pressures taken with the standard sphygmomanometer. With the random zero device, the pooled estimated slopes for the regression of standard systolic and diastolic pressures on the zero level were -0.71 and -0.17, respectively (both p < 0.0001). The only plausible explanation for this relation between the random zero device and the standard device is that by some unknown mechanism the subject's blood pressure is influencing the zero level. Systolic and diastolic blood pressures measured with the random zero device were, respectively, 1.65 and 1.84 mm Hg lower (both p < 0.0001) than standard blood pressures. Digit preference was detectable in the uncorrected blood pressure and zero level measured with the random zero device but was eliminated after calculation of the corrected blood pressure. For most epidemiological studies, the random zero sphygmomanometer offers no significant advantage over the standard sphygmomanometer. It may still be useful in those epidemiological studies and clinical trials where blinding is important.

10aAged10aBlood Pressure10aBlood Pressure Determination10aCohort Studies10aDiastole10aHumans10aRegression Analysis10aSystole1 aKronmal, R, A1 aRutan, G, H1 aManolio, T A1 aBorhani, N O uhttps://chs-nhlbi.org/node/144703702nas a2200409 4500008004100000022001400041245015600055210006900211260001600280300001200296490000700308520256000315653001602875653000902891653002202900653001002922653001902932653002102951653002102972653001102993653001103004653003403015653000903049653001603058653001203074100001603086700001703102700002003119700001603139700001603155700002303171700001703194700001303211700001503224700001703239856003603256 1995 eng d a0009-732200aSex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly. The Cardiovascular Health Study.0 aSex age and disease affect echocardiographic left ventricular ma c1995 Mar 15 a1739-480 v913 a

BACKGROUND: Left ventricular (LV) hypertrophy, as measured by M-mode echocardiography, is an independent predictor of mortality and/or morbidity from coronary heart disease (CHD). LV global and segmental systolic dysfunction also have been associated with myocardial ischemia and cardiovascular morbidity and mortality. Echocardiographic data, especially two-dimensional, have not been available previously from multicenter-based studies of the elderly. This report describes the distribution and relation at baseline of echocardiographic LV mass and global and segmental LV wall motion to age, sex, and clinical disease category in the Cardiovascular Health Study (CHS), a cohort of 5201 men and women (4850 white) 65 years of age and older.

METHODS AND RESULTS: M-mode LV mass adjusted for body weight increased modestly with age (P < .0001), increasing less than one gram per year increase in age for both men and women. After adjustment for weight, LV mass was significantly greater in men than in women and in participants with clinical CHD compared with participants with neither clinical heart disease nor hypertension (both P < .001). Across all CHS age subgroups, the difference in weight-adjusted LV mass by sex was greater in magnitude than the difference related to clinical CHD. M-mode measurements of LV mass could not be made in 34% of CHS participants, and this was highly related to age (29% in the 65 to 69 year versus 50% in the 85+ year age group, P < .001) and other risk factors. In participants with clinical CHD and with neither clinical heart disease nor hypertension, LV ejection fraction and segmental wall motion abnormalities were more prevalent in men than women (all P < .001). Of interest, 0.5% of men and 0.4% of women with neither clinical heart disease nor hypertension had LV segmental wall motion abnormalities, suggesting silent disease, compared with 26% of men and 10% of women in the clinical CHD group (P < .0001). Multivariate analyses revealed male sex and presence of clinical CHD (both P < .001) to be independent predictors of LV akinesis or dyskinesis.

CONCLUSIONS: Significant baseline relations were detected between differences in sex, prevalent disease status, and echocardiographic measurements of LV mass and systolic function in the CHS cohort. Age was weakly associated with LV mass measurements and LV ejection fraction abnormalities. These relations should be considered in evaluating the preclinical and clinical effects of CHD risk factors in the elderly.

10aAge Factors10aAged10aAged, 80 and over10aAging10aCohort Studies10aCoronary Disease10aEchocardiography10aFemale10aHumans10aHypertrophy, Left Ventricular10aMale10aSex Factors10aSystole1 aGardin, J M1 aSiscovick, D1 aAnton-Culver, H1 aLynch, J, C1 aSmith, V, E1 aKlopfenstein, H, S1 aBommer, W, J1 aFried, L1 aO'Leary, D1 aManolio, T A uhttps://chs-nhlbi.org/node/1422