Abstract-Pressure wave reflection in the upper limb causes amplification of the arterial pulse so that radial systolic and pulse pressures are greater than in the ascending aorta. Wave transmission properties in the upper limbs (in contrast to the descending aorta and lower limbs) change little with age, disease, and drug therapy in adult humans. Such consistency has led to use of a generalized transfer function to synthesize the ascending aortic pressure pulse from the radial pulse. Validity of this approach was tested for estimation of aortic systolic, diastolic, pulse, and mean pressures from the radial pressure waveform. Ascending aortic and radial pressure waveforms were recorded simultaneously at cardiac surgery, before initiation of cardiopulmonary bypass, with matched, fluid-filled manometer systems in 62 patients under control conditions and during nitroglycerin infusion. Aortic pressure pulse waves, generated from the radial pulse, showed agreement with the measured aortic pulse waves with respect to systolic, diastolic, pulse, and mean pressures, with mean differences Ͻ1 mm Hg. Control differences in Bland-Altman plots for meanϮSD in mm Hg were systolic, 0.0Ϯ4.4; diastolic, 0.6Ϯ1.7; pulse, Ϫ0.7Ϯ4.2; and mean pressure, Ϫ0.5Ϯ2.0. For nitroglycerin infusion, differences respectively were systolic, Ϫ0.2Ϯ4.3; diastolic, 0.6Ϯ1.7; pulse, Ϫ0.8Ϯ4.1; and mean pressure, Ϫ0.4Ϯ1.8.

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