The arterial pulse wave and vascular compliance

For just over 1 century, we have relied on cuff sphygmomanometry to measure blood pressure at a peripheral (brachial) site. This measurement provides a quantitative snapshot of hemodynamic activity at 1 part of the arterial tree. Because the heart and brain are exposed to central (aortic) and not peripheral (brachial) pressure, it might be timely for nurses to start looking at alternative techniques to provide more meaningful information on central hemodynamics. The noninvasive technique of applanation tonometry allows such measurements to be performed quickly in the nursing clinic. By analyzing the pulse wave and calculating pulse wave velocity, the technique also assesses arterial "stiffness." This method of cardiovascular assessment further enables nurses to monitor the central effects of antihypertensive, lipid lowering, and other drug therapy over time.