3.2 VARIABILITY IN MEAN ARTERIAL PRESSURE AND DIASTOLIC BLOOD PRESSURE FROM CENTRAL TO PERIPHERAL LARGE ARTERIES: RELEVANCE TO ARTERIAL PHYSIOLOGY AND ESTIMATED CENTRAL BLOOD PRESSURE

DOI

10.1016/j.artres.2016.10.012How to use a DOI?

Abstract

Background: Mean arterial pressure (MAP) and diastolic blood pressure (DBP) are thought to consistently decline approximately 1–3 mmHg from the aorta to peripheral large arteries, thus providing a small pressure gradient to aid blood flow. The magnitude of this gradient is important for correct waveform calibration and central BP estimation. However, there is little invasive data determining the variability in MAP and DBP from central to peripheral arteries, which was the goal of this study.

Methods: 52 patients (mean age 62±11 years) undergoing cardiac angiography had intra-arterial BP measured via catheter in the ascending aorta, brachial and radial arteries by sequential pull-back. MAP was calculated by integration of ensemble averaged waveforms, and DBP from the foot of the waveforms.

Results: On average, MAP and DBP decreased from the aorta-to-brachial (MAP −1.5±3.9 mmHg DBP −2.7±4.1 mmHg) and brachial-to-radial (MAP −2.0±4.4 mmHg DBP −1.8±3.3 mmHg) arteries. However, changes in aortic-to-radial MAP (range −14.9 to 6.8 mmHg) and DBP (range −13.1 to 2.1 mmHg) were highly variable, including increases in MAP among 23% of patients. Importantly, the relationship between MAP and DBP changes were synergistic, with DBP decreasing if MAP increased and vice versa. The magnitude of aorta-to-radial MAP and DBP differences were significantly related to height and age.

Conclusions: Although MAP and DBP are reduced on average from central to peripheral large arteries, the magnitude of change is variable and related to patient characteristics. These new observations are highly relevant to understanding arterial hemodynamic (patho)physiology and accurate non-invasive estimates of central BP.

Open Access

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

TY  - JOUR
AU  - Martin Schultz
AU  - Dean Picone
AU  - Xiaoqing Peng
AU  - Andrew Black
AU  - Nathan Dwyer
AU  - Phillip Roberts-Thomson
AU  - James Sharman
PY  - 2016
DA  - 2016/11/24
TI  - 3.2 VARIABILITY IN MEAN ARTERIAL PRESSURE AND DIASTOLIC BLOOD PRESSURE FROM CENTRAL TO PERIPHERAL LARGE ARTERIES: RELEVANCE TO ARTERIAL PHYSIOLOGY AND ESTIMATED CENTRAL BLOOD PRESSURE
JO  - Artery Research
SP  - 51
EP  - 51
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.012
DO  - 10.1016/j.artres.2016.10.012
ID  - Schultz2016
ER  -