Central pressure should be used in clinical practice

DOI

10.1016/j.artres.2014.11.001How to use a DOI?

Keywords

Haemodynamic; Aorta; Blood vessels; Brachial artery

Abstract

The original purpose for recording brachial blood pressure (BP) more than 100 years ago was to estimate central (aortic) BP. While high brachial BP is an important cardiovascular risk factor, it is clear that major differences in central systolic BP (SBP; e.g. >30 mmHg) can occur among people with similar brachial SBP. It is also proven that central SBP responses to antihypertensive therapy can differ substantially from brachial SBP responses, such that true treatment effects cannot be gauged from conventional brachial BP. Importantly, assessment of central BP results in: 1) improved predictive accuracy of future cardiovascular events beyond brachial BP and other cardiovascular risk factors; 2) superior diagnostic accuracy over brachial BP and; 3) different patient management than usual care guided by brachial BP. Collectively, the above illustrates that central BP is a better cardiovascular risk biomarker than brachial BP. As with all medical advances there are areas of research need and international consensus is required on issues such as standardization of techniques. However, central BP can now be accurately estimated (with appropriate waveform calibration) using brachial cuff methods in an approach that is familiar to clinicians, acceptable to patients and amenable to widespread use. In other words, this modern BP technique can finally satisfy the original purpose for measuring central aortic BP as intended more than 100 years ago. Although the tipping point towards routine use is yet to be reached, the body of evidence continues to favour the view that central BP should be used in clinical practice.

Copyright

© 2014 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.

Open Access

This is an open access article distributed under the CC BY-NC license.

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TY  - JOUR
AU  - James E. Sharman
PY  - 2014
DA  - 2014/12/04
TI  - Central pressure should be used in clinical practice
JO  - Artery Research
SP  - 1
EP  - 7
VL  - 9
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2014.11.001
DO  - 10.1016/j.artres.2014.11.001
ID  - Sharman2014
ER  -