Background: The prognostic value of central blood pressure has been recently established, and the important role of cuff-based ambulatory blood pressure measurement has been clarified. An algorithm enabling conventional automated oscillatory upper-arm cuffs to assess central pressures in addition to brachial measurements could be of clinical value.

Methods: We compared central systolic blood pressure (cSBP), calculated with the ARCSolver method (Austrian Institute of Technology, Vienna, Austria) using waveforms recorded with a regular oscillatory brachial cuff suitable for ambulatory measurement (mobil-o-graph, IEM, Germany), with simultaneous high-fidelity invasive recordings using Millar catheters during routine coronary angiography, and with non-invasive estimations using a FDA-approved validated device (SphygmoCor, AtCor medical, Sydney, Australia).

Results: Both studies revealed a good agreement between the ARCSolver-based cSBP and the comparator. In the invasive study, comprising 18 patients, mean difference between cSBP (ARCSolver) and cSBP (invasive) was −0.3 mm Hg with a standard deviation of 4.5 mm Hg – Figure. In the non-invasive study, comprising 103 patients, mean difference between cSBP (ARCSolver) and cSBP (SphygmoCor) was −0.5 mm Hg with a standard deviation of 4.6 mm Hg. Both results pass the AAMI limits for blood pressure measurement devices.

Conclusion: The ARCSolver algorithm, using brachial cuff-based waveform recordings, is suited to provide a realistic estimation of cSBP.