Arterial blood pressure measurement and pulse wave analysis-–their role in enhancing cardiovascular assessment

Abstract

The most common method of clinical measurement of arterial blood pressure is by means of the cuff sphygmomanometer. This instrument has provided fundamental quantitative information on arterial pressure in individual subjects and in populations and facilitated estimation of cardiovascular risk related to levels of blood pressure obtained from the brachial cuff. Although the measurement is taken in a peripheral limb, the values are generally assumed to reflect the pressure throughout the arterial tree in large conduit arteries. Since the arterial pressure pulse becomes modified as it travels away from the heart towards the periphery, this is generally true for mean and diastolic pressure, but not for systolic pressure, and so pulse pressure. The relationship between central and peripheral pulse pressure depends on propagation characteristics of arteries. Hence, while the sphygmomanometer gives values of two single points on the pressure wave (systolic and diastolic pressure), there is additional information that can be obtained from the time-varying pulse waveform that enables an improved quantification of the systolic load on the heart and other central organs. This topical review will assess techniques of pressure measurement that relate to the use of the cuff sphygmomanometer and to the non-invasive registration and analysis of the peripheral and central arterial pressure waveform. Improved assessment of cardiovascular function in relation to treatment and management of high blood pressure will result from future developments in the indirect measurement of arterial blood pressure that involve the conventional cuff sphygmomanometer with the addition of information derived from the peripheral arterial pulse.

Conformable amplified lead zirconate titanate sensors with enhanced piezoelectric response for cutaneous pressure monitoring

“…The traditional cuff sphygmomanometer is one of the oldest and most established diagnostic tools for blood pressure, but it is not well suited for continuous monitoring and yields only two basic pressure values: systolic (greatest heart contraction) and diastolic (greatest heart dilation) 20 . As a result, capabilities for use in observation during hypertensive treatment, in evaluation for hemodynamic effects of atherosclerotic risk factors or in projections of life-threatening cardiovascular events 21 are limited.…”

Development of a new characteristic parameter – waveform index of finger blood volume pulse

“…Other researches focus on putting forward the new pulse wave analysis approach. [7,8] Recently, researchers are paying attention to estimate the cardiovascular disease based on the pulse waveform characteristics, [9][10][11] however, these researches were analyzed with the radial pulse, aorta pulse and the brachial-ankle pulse. These signals have the same problem of difficulty to detect compared to the F-BVP, and the operator needs be professionally trained.…”

Measuring the Hemodynamic Flow in the Brachial-Ulnar-Radial Arterial System

“…Recent studies suggest that the central blood pressure is more significant and rich in information than the peripheral pressure, although the last one is much easier obtained, and measurement techniques based on pulse wave analysis provide data on hemodynamic parameters, useful for the cardiovascular diagnostic [8], [9].…”