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Published on: May 3, 2018
Central blood pressure reflects left ventricular load, while brachial blood pressure reflects arterial damage
Sumiyo Yamashita1, Yasuaki Dohi, Hiroyuki Takase
1Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences , Nagoya , Japan.
Insights
Central blood pressure (SBP2) is more linked to left ventricular load, while brachial blood pressure is more associated with vascular damage in the general population. Both play distinct roles in cardiovascular health.
Area of Science:
- Cardiovascular Physiology
- Hypertension Research
- Clinical Diagnostics
Background:
- Brachial blood pressure is a standard clinical measurement.
- Central blood pressure offers insights into arterial hemodynamics.
- Understanding differential impacts on cardiovascular health is crucial.
Purpose of the Study:
- To investigate the distinct effects of brachial and central blood pressures on the cardiovascular system.
- To compare the association of brachial and central blood pressures with biomarkers of cardiac strain and vascular damage.
Main Methods:
- Cross-sectional analysis of 706 individuals undergoing physical check-ups.
- Measurement of brachial blood pressure and radial artery pressure waveforms.
- Assessment of B-type natriuretic peptide and carotid intima-media thickness.
Main Results:
- Central blood pressure (SBP2) independently correlated with B-type natriuretic peptide, indicating a link to left ventricular load.
- Brachial systolic blood pressure independently correlated with carotid artery intima-media thickness, suggesting an association with vascular damage.
- Both measures showed univariate correlations with B-type natriuretic peptide.
Conclusions:
- Central blood pressure is a stronger indicator of left ventricular load.
- Brachial blood pressure is a more significant predictor of vascular damage.
- These findings highlight the complementary roles of central and brachial blood pressure in cardiovascular risk assessment.
Objectives:
The present study investigated whether brachial and central blood pressures have differential impact on the cardiovascular system in the general population.
Methods:
The study included 706 subjects (59 ± 10 years) who visited our hospital for a physical check-up. Brachial blood pressure and radial artery pressure waveforms were recorded using an automated device, and the pressure corresponding to the radial late systolic peak (SBP2) was taken as central blood pressure. The concentration of B-type natriuretic peptide and the intima-media thickness of the carotid artery were measured and a cross-sectional analysis was performed.
Results:
Brachial blood pressure was 128 ± 18/74 ± 12 (mean blood pressure, 92 ± 13) mmHg and SBP2 was 120 ± 19 mmHg. Although both brachial systolic blood pressure and SBP2 correlated with B-type natriuretic peptide in a univariate analysis, only SBP2 independently correlated with B-type natriuretic peptide after adjustment for possible factors. In contrast, brachial systolic blood pressure, but not SBP2, independently correlated with carotid artery intima-media thickness.
Conclusions:
Central blood pressure is more closely associated with left ventricular load than brachial blood pressure, while brachial blood pressure is more strongly associated with vascular damage than central blood pressure.
Related Concept Videos
01:17Measurement of Blood Pressure
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:23Assessment of blood pressure in brachial artery(two-step method)
01:21Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.