Noninvasive Studies of Central Aortic Pressure

Abstract

Our purpose is to review noninvasive methods for measuring central arterial pressure. Indices of central arterial pressure measured from central aortic and peripheral arterial waveforms have shown value in predicting cardiovascular events and death, as well as in guiding therapeutic management. This article reviews noninvasive techniques of measuring central arterial pressure that have been validated against intra-arterial pressure. This paper explains methods to derive central (aortic and carotid) pressure from radial and brachial sites. It focuses on specific issues of brachial calibration applied to carotid pressure waveforms, which were regarded as a surrogate of aortic pressures used in three major studies (Framingham, Asklepios, and Australian National Blood Pressure 2 studies). We explain why radial-based methods are superior to carotid-based methods for estimating central pressure. Physiological principles of pressure measurement need be satisfied to ensure accurate recording.

Derivation and Validation of Diagnostic Thresholds for Central Blood Pressure Measurements Based on Long-Term Cardiovascular Risks

“…The techniques used to measure CBP in the derivation and validation cohorts were carotid tonometry and generalized transfer function with a SphygmoCor monitor, respectively, which are currently the 2 most popular CBP measurement methods (52). Whether the same reference values should be used for different methodologies is not clear.…”

Combination therapy with lercanidipine and enalapril reduced central blood pressure augmentation in hypertensive patients with metabolic syndrome

“…Thus, the findings cannot be extended to longer treatment duration or a general hypertensive population. It is known that a large component of error in SphygmoCor-derived central BP is accuracy of measured brachial BP [27], which could have influenced results. Finally, AIx is an integrated index of arterial stiffness and wave reflection; the latter could be investigated more precisely only with a concomitant measurement of aortic blood flow for separating forward and backward waves [28].…”

Associations of plasma homocysteine levels with peripheral systolic blood pressure and noninvasive central systolic blood pressure in a community-based Chinese population

“…Therefore, cSBP has different physiology and may offer improvements in CVD risk assessment compared to pSBP. Currently, cSBP can be assessed noninvasively through the use of several devices 19 . cSBP is associated with age, sex, brachial BP, heart rate, pulse wave velocity, and many other risk factors, such as body mass index (BMI), lipids and diabetes 20 .…”