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2.6 Non-Invasive Estimation of Exercise Central Blood Pressure by Radial Tonometry May be Underestimated Due to Brachial-To-Radial-Systolic-Blood-Pressure-Amplification and is Related to Upper Limb Blood Flow Velocity

Abstract

Objectives

Both central blood pressure (BP) and light-moderate exercise BP are independently associated with cardiovascular risk, and measuring central BP during exercise may have clinical relevance. Brachial-to-radial-systolic-blood-pressure-amplification (B-R-SBPAMP) could influence the accuracy of central SBP estimation by radial tonometry during exercise. This study aimed to determine the influence of light-moderate exercise on B-R-SBPAMP and consequent central SBP estimation. Independent correlates of B-R-SBPAMP were also explored.

Methods

Sixty healthy participants (39±16 years, 50% male) underwent testing during light-moderate intensity (40W, 50RPM) semi-recumbent cycling. SBP was identified by brachial and radial ultrasound (1st Doppler flow inflection = 1st Korotkoff sound during cuff deflation). Haemodynamics were recorded by ultrasound and tonometry. Bra-Rad-SBPAmp was defined as radial minus brachial SBP.

Result

Exercise radial SBP was significantly higher than brachial SBP (144±21 versus 134±17 mmHg; p<0.001). Exercise Bra-Rad-SBPAmp was 10±11 mmHg and increased with advancing age (r = 0.360, p = 0.005). Exercise central SBP was significantly higher when radial tonometry was calibrated with radial SBP (accounting for Bra-Rad-SBPAmp) versus brachial SBP (117±16 versus 110±13 mmHg, p<0.001). Low brachial peak flow velocity relative to radial velocity was negatively associated with exercise B-R-SBPAmp (r = -0.439, p = 0.001), independent of age, sex, heart rate and mean arterial pressure (β = -0.389, adjusted R2 = 0.273, p = 0.003).

Conclusions

Significant Bra-Rad-SBPAmp exists during light-moderate exercise. This will result in underestimation of central SBP unless Bra-Rad-SBPAmp is considered and is influenced by variation in peak blood flow velocity magnitude between the brachial and radial arteries.

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This is an open access article distributed under the CC BY-NC license http://creativecommons.org/licenses/by/4.0/.

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Picone, D., Climie, R., Keske, M. et al. 2.6 Non-Invasive Estimation of Exercise Central Blood Pressure by Radial Tonometry May be Underestimated Due to Brachial-To-Radial-Systolic-Blood-Pressure-Amplification and is Related to Upper Limb Blood Flow Velocity. Artery Res 8, 124–125 (2014). https://doi.org/10.1016/j.artres.2014.09.062

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.062