Clinical assessment of central blood pressure

H Miyashita - Current hypertension reviews, 2012 - ingentaconnect.com
Current hypertension reviews, 2012ingentaconnect.com
Central aortic blood pressure (CBP) is increasingly considered a better cardiovascular
prognostic marker than conventional cuff brachial blood pressure. Because CBP cannot be
directly measured noninvasively, it has to be estimated from peripheral pressure pulses. To
assess estimated CBP appropriately, the accuracy and features of the estimation method
should be considered. The aim of this review is to provide basic knowledge and information
useful for interpreting and assessing estimated CBP from a methodological point of view …
Central aortic blood pressure (CBP) is increasingly considered a better cardiovascular prognostic marker than conventional cuff brachial blood pressure. Because CBP cannot be directly measured noninvasively, it has to be estimated from peripheral pressure pulses. To assess estimated CBP appropriately, the accuracy and features of the estimation method should be considered. The aim of this review is to provide basic knowledge and information useful for interpreting and assessing estimated CBP from a methodological point of view. Precise peripheral pressure pulse recording has been enabled by the introduction of arterial applanation tonometry, for which the radial artery may be the optimal site. An automated tonometry device utilizing a sensor array is preferable in terms of reproducibility and objectivity. Calibration of a peripheral pressure waveform has unresolved problems for any estimation method, due to imperfect brachial sphygmomanometry. However, if central and peripheral pressure calibrations are equivalent, two major methods to estimate CBP—those based on generalized pressure transfer function or radial late systolic pressure—may be comparable in their accuracy of CBP parameter estimation.
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