Noninvasive Measurement of Central Vascular Pressures With Arterial Tonometry: Clinical Revival of the Pulse Pressure Waveform?

Nelson, Matthew R.; Stepanek, Jan; Cevette, Michael; Covalciuc, Michael; Todd Hurst, R.; A. Jamil Tajik
May 2010
Mayo Clinic Proceedings;May2010, Vol. 85 Issue 5, p460
Academic Journal
The arterial pulse has historically been an essential source of information in the clinical assessment of health. With current sphygmomanometric and oscillometric devices, only the peak and trough of the peripheral arterial pulse waveform are clinically used. Several limitations exist with peripheral blood pressure. First, central aortic pressure Is a better predictor of cardiovascular outcome than peripheral pressure. Second, peripherally obtained blood pressure does not accurately reflect central pressure because of pressure amplification. Lastly, antihypertensive medications have differing effects on central pressures despite similar reductions in brachial blood pressure. Applanation tonometry can overcome the limitations of peripheral pressure. by determining the shape of the aortic waveform from the radial artery. Waveform analysis not only indicates central systolic and diastolic pressure but also determines the influence of pulse wave reflection on the central pressure waveform. It can serve as a useful adjunct to brachial blood pressure measurements in initiating and monitoring hypertensive treatment, in observing the hemodynamic effects of atherosclerotic risk factors, and in predicting cardiovascular outcomes and events. Radial artery applanation tonometry is a noninvasive, reproducible, and affordable technology that can be used in conjunction with peripherally obtained blood pressure to guide patient management. Keywords for the PubMed search were applanation tonometry, radial artery, central pressure, cardiovascular risk, blood pressure, and arterial pulse. Articles published from January 1, 1995, to July 1, 2009, were included in the review if they measured central pressure using radial artery applanation tonometry.


Related Articles

  • Stable plasma magnesium status in essential hypertensive patients treated with angiotensin II antagonists (a follow-up study). Kisters, K.; Rempel, V.; Kabar, I.; Cziborra, M.; Funke, C.; Wessels, F.; Tokmak, F.; Gremmler, B.; B√ľntzel, J.; Liebscher, H.; Hausberg, M. // Trace Elements & Electrolytes;2007 4th Quarter, Vol. 24 Issue 4, p244 

    Lowered Mg++ stores in humans seem to be involved in the pathogenesis of essential hypertension. However, some antihypertensive drugs (e.g. in particular diuretics) can additionally decrease plasma or intracellular Mg++ stores. In this context, the role of the new antihypertensive angiotensin II...

  • VALTURNA 150mg/160mg.  // Monthly Prescribing Reference;Dec2009, Vol. 25 Issue 12, pA21 

    The article offers information on Valturna 150milligrams (mg)/160mg antihypertensive agent from Novartis AG. The drug acts as monotherapy for hypertension or with other antihypertensives. As initial therapy in patients probably require multiple drugs to attain blood pressure goals. Valturna...

  • Design, Synthesis, and Biological Evaluation of AT1 Angiotensin II Receptor 2 Substituted phenyl-(phenyl-{1- [2-(1H-tetrazol-5-yl)-biphenyl-4-ylmethyl]-1H-benzoimidazol-5-ylamine. Sharma, Mukesh Chandra; Kohli, Dharm Veer; Sharma, Smita // International Journal of ChemTech Research;Jul-Sep2010, Vol. 2 Issue 3, p1618 

    Synthesis of a series of novel substituted benzimidazole derivatives by the condensation of ophenylenediamine (OPDA,) with Mandlic acid and subsequent reactions of the benzimidazole with different amino substituted is reported with reaction biphenyl tetrazole. All the compounds synthesized were...

  • Azilsartan Improves Salt Sensitivity by Modulating the Proximal Tubular Na+-H+ Exchanger-3 in Mice. Hatanaka, Masaki; Kaimori, Jun-Ya; Yamamoto, Satoko; Matsui, Isao; Hamano, Takayuki; Takabatake, Yoshitsugu; Ecelbarger, Carolyn M.; Takahara, Shiro; Isaka, Yoshitaka; Rakugi, Hiromi // PLoS ONE;1/25/2016, Vol. 11 Issue 1, p1 

    A potent angiotensin II type-1 receptor blocker, azilsartan, has been reported to reduce blood pressure more effectively than candesartan. Interestingly, azilsartan can also restore the circadian rhythm of blood pressure. We hypothesized that azilsartan could also improve salt sensitivity; thus,...

  • Impact of antihypertensive medication adherence on blood pressure control in hypertension: the COMFORT study. Matsumura, K.; Arima, H.; Tominaga, M.; Ohtsubo, T.; Sasaguri, T.; Fujii, K.; Fukuhara, M.; Uezono, K.; Morinaga, Y.; Ohta, Y.; Otonari, T.; Kawasaki, J.; Kato, I.; Tsuchihashi, T. // QJM: An International Journal of Medicine;Oct2013, Vol. 106 Issue 10, p909 

    Background: It has not been fully elucidated whether antihypertensive medication adherence affects blood pressure (BP) control in hypertension cases.Aim: To investigate the association of adherence to antihypertensive drug regimens and BP control using data from the Combination Pill of Losartan...

  • Imidapril: A Review of its Use in Essential Hypertension, Type 1 Diabetic Nephropathy and Chronic Heart Failure. Robinson, Dean M.; Curran, Monique P.; Lyseng-Williamson, Katherine A. // Drugs;2007, Vol. 67 Issue 9, p1359 

    Imidapril (Tanatril), through its active metabolite imidaprilat, acts as an ACE inhibitor to suppress the conversion of angiotensin I to angiotensin II and thereby reduce total peripheral resistance and systemic blood pressure (BP).In clinical trials, oral imidapril was an effective...

  • Glaucoma treatment advances. Dubiner, Harvey; Groves, Nancy // Ophthalmology Times;1/15/2013, Vol. 38 Issue 2, p34 

    The article offers information on an integrated analysis of seven trials of travoprost ophthalmic solution. It mentions that Travatan from Alcon Laboratories Inc., which comprises of 0.004 percent of travoprost, dosed once daily in the evening showed a robust 30 percent reduction in intraocular...

  • Role of Vitamin C and E supplementation in reduction of serum level of renal injury marker following shock wave lithotripsy: Prospective single centre experience. Modi, Jayesh; Modi, Pranjal; Pal, Bipinchandra; Bansal, Jyoti; Kumar, Suresh; Nagarajan, Ramya; Saifee, Yusuf // Urology Annals;Jul2015, Vol. 7 Issue 3, p350 

    Introduction: Shock wave lithotripsy has become first line treatment modality for renal calculi due to its noninvasiveness. However, the destructive forces like dispersion of cavitation bubbles can cause trauma to thin-walled vessels and renal parenchyma during fragmentation of the stones....

  • Losartan Potassium Oral Administration Decreased Intraocular Pressure in Humans: A Pilot Study. Costagliola, C.; Verolino, M.; Iaccarino, G.; derosa, M.L.; Ciancaglini, M.; Mastropasqua, L. // Clinical Drug Investigation;1999, Vol. 17 Issue 4, p329 

    Examines the effects of losartan potassium on intraocular pressure in control subjects and in patients with essential arterial hypertension. Adverse effects; Mechanisms of action; Systolic and diastolic arterial pressure variations.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics