The Importance of Central Blood PressureThe Importance of Central Blood PressureAtcor_Logo_30hThe Importance of Central Blood Pressure
  • Solutions
    • Clinical Trials
      • Overview
      • Hypertension
      • Renal Disease
      • Heart Failure
      • Cognitive Impairment
      • Diabetes
      • COPD
    • Research
    • Clinical Practice
  • Technology
    • NcBP
    • SphygmoCor®
    • Oscar 2 With SphygmoCor® Inside
    • Arty Heart Health – TicWatch GTH Pro
      • Arty Heart Health Platform
      • Watching Your Heart Health
      • Visit GTH Pro
      • Buy GTH Pro Now
  • Resources
    • Publications
    • Case Studies
    • Newsletter
    • Videos
    • Webinars
    • White Papers
  • Customers
    • Register
    • Customer Log-in
  • About
    • Overview
    • Team
    • Advisory Board
    • Intellectual Property
    • News & Media
    • ASX Announcements
  • Blog
  • Contact
    • Contact Us
    • Technical support

The Importance of Central Blood Pressure

Published by Amy Synnott on March 17, 2023

In the United States, one person dies every 40 seconds from cardiovascular disease, according to the CDC. And the problem is just getting worse: Between 2005-2018, the number of people dying from blood pressure-related deaths soared by 38%. 

Under the newest guidelines, which were revised in 2018, nearly half of all American adults now meet the criteria for high blood pressure (defined as a reading over 130/80 mmHG), yet up to a third of these high-risk patients don’t even realize they have it, according to the American Heart Association. One reason people are being underdiagnosed? Experts say current diagnostic protocols—which often don’t include regular monitoring of central blood pressure—allow many people suffering from this silent killer to fall through the cracks. 

Research shows that central aortic systolic pressure is a more reliable and sensitive predictor of heart disease, stroke, vascular disease and kidney failure than traditional brachial blood pressure. 

“A traditional brachial cuff measures pressure in your arm, but that’s not the same as the pressure in your heart,” the Director of Hypertension at the University of Pennsylvania School of Medicine, Raymond Townsend, M.D., says. To get an accurate picture of cardiovascular risk, he says you need to measure central aortic systolic pressure because it reflects key factors like arterial stiffness—a measure of the rigidity of blood vessel walls. 

How Arterial Stiffness Affects Central Blood Pressure 

As people age, their blood vessels (particularly the large aortic ones) become less elastic, which makes it harder for the heart to pump. This condition, known as arterial stiffness, causes blood to move more quickly through the arteries, increasing blood pressure. 

“It’s like a guitar string,” Townsend says. “The tighter you make it, the higher the pitch and—in the case of circulation — the faster the blood flows.” 

While arterial stiffness (which is measured in pulse wave velocity — the speed at which waves move down the vessels) increases in the aorta with each decade, pulse wave velocity (or PWV)  stays relatively stable in the smaller arteries as you age, Townsend says. This explains why systolic pressure may be up to 40 mmHg higher in the brachial artery than in the central aorta. 

What is Central Blood Pressure?   

This term refers to pressure in the ascending aorta, the large artery that pumps blood from the heart to the target organs (brain, heart and kidneys). Because it measures pressure at the area where it matters most, researchers believe it provides a more complex and nuanced view of vascular health than traditional brachial blood pressure and is more accurate at assessing the probability of cardiovascular problems like heart attack and stroke, as well as the possibility of end-organ damage such as kidney disease and Alzheimer’s.  

Historically, doctors have relied on instruments called sphygmomanometers to measure blood pressure at the brachial artery, the main vessel that supplies blood to the muscles in your upper arm and elbow. This is known as peripheral blood pressure. 

But this reading paints an incomplete picture because systolic pressure varies as blood travels along the arterial tree away — the branching system of arteries—from the heart toward the peripheral organs. As Dr. Townsend noted, the large arteries, particularly the aorta, become stiffer with age than peripheral vessels do, which makes central aortic pressure a more accurate predictor of risk. 

Until recently, the only way to measure central blood pressure was to insert an invasive arterial catheter into a patient. Doctors would then measure the speed at which the blood traveled (pulse wave velocity) from the aorta to the peripheral arteries (say, the femoral artery in the leg) by dividing the distance from the time it takes to travel there. The invasive nature of this technique precluded it from being adopted in wide scale clinical studies and everyday practice. 

How Central Blood Pressure Is Measured Now

In recent years, technological advances have made it possible for doctors to measure central blood pressure non-invasively using devices like a SphygmoCor machine. Using pulse wave analysis and pulse wave velocity, these devices can provide a much more accurate picture of arterial stiffness and other key predictors of hypertension and cardiovascular disease.

“With a traditional brachial cuff, we just get to see the top of the curve [systole] and the bottom [diastole] and all the other info is lost,” Dr. Raffaele says. “The SphygmoCor is really the gold standard for blood pressure measurement these days. The shape of the wave tells us a lot about the health of the arterial tree.”   

Do You Have Hypertension? 

Central Blood Pressure

Optimal: under 110/80 mmHg

Prehypertension: 110–129/80–89 mmHg

Peripheral Blood Pressure

Hypertension: greater than or equal to 130/90 mmHg 

Hypertension (Stage 1): 130-139/80-89

Hypertension (Stage 2): 140+/90+

Hypertensive Crisis: >180/120 

References 

  1. Fryar CD, Chen T-C, Li X. Prevalence of uncontrolled risk factors for cardiovascular disease: United States, 1999–2010 . National Center for Health Statistics; 2012. 
  2. American Heart Association, 2018, More than 100 million Americans have high blood pressure, AHA says, Heart Association News  
  3. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association, Circulation2020;141:e139-596.
  4. Enrico Agabiti-Rosei et al, (2007). Central Blood Pressure Measurements and Antihypertensive Therapy, Hypertension, 154-160
  5. McEniery, C et al. (2014). Central Blood Pressure: Current Evidence and Clinical Importance. European Heart Journal , Volume 35, Issue 26, 7 July 2014, Pages 1719–1725
  6. Mary Roman et al. High central pulse pressure is independently associated with adverse cardiovascular outcomes,  The strong heart study, 2009. Journal of the American College of Cardiology, 1730-4. 
  7. Gary Mitchell, (2008) Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage, Journal of Applied Physiology, 1652–1660.
  8. Mark Butlin, Ahmad Qasem (2017), Large Artery Stiffness Assessment Using SphygmoCor Technology.Pulse (Basel),  180–192.
  9. Joseph Bulas et al. (2017), Central Systolic Hypertension in Patients with Well-Controlled Hypertension, Biomedical Research International 
  10. Cheng, Y., et al. (2022). Risk Stratification by Cross-Classification of Central and Brachial Systolic Blood Pressure. Hypertension, 79(5), 1101-1111.  TEMPLATE 
  11. American Heart Association, Understanding Blood Pressure Readings

Share

Related posts

Covid 19 and blood cells
March 20, 2023

How Cardiovascular Health Impacts Covid Outcomes


Read more
Man sleeping
March 17, 2023

How Sleep Affects Cardiovascular Health


Read more
Older women with Alzheimer's in wheelchair
March 17, 2023

High Blood Pressure and Alzheimer’s Disease


Read more
Sign up for our VITALITY newsletter

Select list(s) to subscribe to


By submitting this form, you are consenting to receive marketing emails from: ATCOR, 184 Shuman Blvd, Naperville, IL, 60563, http://www.atcormedical.com. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact

You can unsubscribe at any time

Subscribe

AtCor Icon

Solutions
Clinical Trials
 - Hypertension
 - Renal Disease
 - Heart Failure
 - Cognitive Impairment
 - Diabetes
 - COPD
Research
Clinical Practice

Technology
NcBP
SphygmoCor®
Oscar 2 With SphygmoCor® Inside

Resources
Publications
Case Studies
Newsletter
Videos
Webinars
White Papers
About
Overview
Team
Advisory Board
Intellectual Property
News & Media
ASX Announcements

Blog

Privacy Policy
Disclaimer
Acceptable Use Policy
Contact Us
Technical Support
Contact Us


+1 (630) 228-8871

[email protected]

The Cardiex group of companies is pleased to be a member of these esteemed professional organizations.
Copyright © 2023 ATCOR. All Rights Reserved.

    Software Downloads – Quick Descriptions

    XCEL Installation Package V1.3

    XCEL V1.3 is the latest ATCOR release of the base XCEL software.  It is a required installation for all clinical practice, academic research, and clinical trials.


    XCEL Secure Data Option Installation Package 

    XCEL Secure Data Option software enables Part11 readiness for clinical practice, academic research, and clinical trials.  Prior to install, confirm that the XCEL V1.3 software is fully installed prior to the XCEL Secure Installation Package. Contact Us for more information.


    Calibration Kit Software

    For customers who have the XCEL calibration kit, this software is used for the annual calibration of the SphygmoCor XCEL.  The SphygmoCor XCEL Calibration Kit, sold separately, is required for this calibration procedure.