How to assess mean blood pressure properly at the brachial artery level

Bos, Willem Jan W.; Verrij, Elisabeth; Vincent, H. H.; Westerhof, Berend E.; Parati, Gianfranco; Montfrans, Gert A. van

doi:10.1097/hjh.0b013e32803fb621

Cited by 144 publications

(96 citation statements)

References 14 publications

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“…Such pressure errors can be 'transferred' by the Central pressure comparison by three devices M Rezai et al transfer function to cSBP estimates. 5,31 In line with the first explanation, our results show that when more accurate estimates of peripheral pressures are used to calibrate SC (that is, method 3), [20][21][22] the cSBP estimates are significantly higher, and less or not different from the two newer devices. Given the evidence on SC's traditional calibration, the relatively higher cSBPs by the two new devices and that from SC calibrated here by method 3 are likely to be closer to real.…”

Section: Discussionsupporting

confidence: 73%

“…Comparisons were repeated after crosscalibrating SC by three methods using three sets of brachial BPs from AG and OM. Method 1 used systolic blood pressure (SBP) and diastolic blood pressure (DBP), method 2, DBP and mean arterial pressure (MAP) calculated by the classic formula: DBP + (PP/3), and method 3, DBP and MAP by a newer formula: DBP + (0.4ÂPP) derived by Bos et al 20 comparing non-invasive and invasive brachial BPs. This has been recommended as a more accurate estimate of brachial MAP.…”

Section: Comparisons and Statistical Analysismentioning

confidence: 99%

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Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

et al. 2011

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The objective of this study was to compare central systolic blood pressure (cSBP) and augmentation index (AIx) from two recently introduced devices, Omron HEM-9000 (OM) and Arteriograph (AG), not using a transfer function with those of the widely used SphygmoCor (SC) calibrated on brachial blood pressure like OM. Random-order manufacturer-recommended measurements using SC and OM by radial tonometry and AG were taken on the left arm in 35 men (54±10 years) after 5 min supine rest. Results are means (95% confidence interval) of differences using paired t-tests. cSBP by OM was 4.1 (1.0-7.1) mm Hg higher than by AG. Both OM and AG estimated the mean cSBP to be significantly higher than did SC (114.8 mm Hg) by 12.5 (10.3-14.7) and 8.6 (4.9-12.3) mm Hg, respectively, although closely correlating with SC (r¼0.9). Calibrating SC with diastolic blood pressure (DBP) and more accurate mean arterial pressure (as DBP+0.4ÂPP) resulted in significantly higher cSBP statistically not different from AG's cSBP: 0.9 (À1.1 to +2.9)mm Hg, and closer to OM's: 5.1 (3.4-6.8)mm Hg. Radial AIx from SC and OM disagreed by 3 (0.7-5.4)%, and correlated (r¼0.8) with AG's brachial AIx. AG's aortic AIx was 7.9 (5.7-10.2)% higher than SC's, but closely correlated (r¼0.9). Clinically significant, higher cSBP measured by AG, OM and more accurately calibrated SC adds to previous data suggesting that SC measurements by classic calibration underestimate cSBP. Invasive studies involving all three devices would be more illuminating. INTRODUCTIONCentral blood pressure (cSBP) and indices of wave reflections have become relevant to cardiovascular risk stratification and hypertension management. The primary organs targeted by hypertensive damage (heart, brain and kidneys) may be exposed more closely to aortic blood pressure (BP) and pulsations rather than that estimated by traditionally measured brachial pressures. 1 Moreover, antihypertensive medications may affect central and peripheral pressures differently 2 which could influence drug efficacy and risk reduction. 3 Our previous data from the CAFE study suggested that one drug class and combination produced greater central but not peripheral BP change based on SphygmoCor (SC). 2 There are still few large cohort studies comparing the prospective value of central versus peripheral (brachial) pressures, but a number of small to medium size studies have demonstrated the value of invasively measured central systolic and pulsating pressures prospectively. 4 Large trials demand quick non-invasive measurement of central pressures.

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Section: Discussionsupporting

confidence: 73%

Section: Comparisons and Statistical Analysismentioning

confidence: 99%

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

et al. 2011

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“…A PAM é a pressão para a distribuição adequada do fluxo e oxigênio para os tecidos e órgãos, sendo dependente, principalmente, do débito cardíaco e da resistência vascular periférica. A PP é caracterizada pelo papel das grandes artérias de minimizar a pulsatilidade e depende da ejeção ventricular, da rigidez arterial e do tempo de reflexão da onda (29) . A PAM e a PP estão associadas ao controle adequado da pressão arterial e a fatores independentes de risco cardiovascular, especialmente para a mortalidade cardíaca em mulheres entre 50 e 60 anos de idade (21) .…”

Section: Discussionunclassified

Efeitos do treinamento de força a longo prazo sobre parâmetros hemodinâmicos e concentração de resistina em mulheres na pós-menopausa

Marin¹,

Santos²,

Botero³

et al. 2013

RBPS

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“…[16] Mean arterial pressure (MAP) was calculated by adding 40% of the pulse pressure (PP) to the measured DBP. [17] Cardiac Output Cardiac output (CO) was measured using echocardiography (AU5, Esaote, Genoa, Italy).…”

Section: Measurementsmentioning

confidence: 99%

The influence of tocolytic drugs on cardiac function, large arteries, and resistance vessels

Fabry

Paepe

Kips

et al. 2011

Eur J Clin Pharmacol

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How to assess mean blood pressure properly at the brachial artery level

Cited by 144 publications

References 14 publications

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

Efeitos do treinamento de força a longo prazo sobre parâmetros hemodinâmicos e concentração de resistina em mulheres na pós-menopausa

The influence of tocolytic drugs on cardiac function, large arteries, and resistance vessels

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