Background. Cuff blood pressure (BP) measurement has been the standard method for taking BP in routine daily
practice for more than a century. However, some concerns were raised about the accuracy of this method which could
lead to misclassification of BP in many situations.
We aimed primarily to confirm a recent major discovery that distinct BP phenotypes based on central-to-peripheral
systolic blood pressure (SBP) amplification do exist, and whether application of a validated cuff BP method (e.g.
oscillometric) could accurately discriminate these differences.
Material and methods. Among 106 participants (mean age 62 ± 11; 58% males) undergoing coronary angiography,
intra-arterial BP was measured at 3 points (ascending aorta, brachial and radial arteries). Central-to-peripheral SBP
amplification (SBPamp) was defined as ≥ 5 mm Hg SBP increased from aorta-to-brachial and/or from brachial-to
radial arteries. A validated cuff BP device (oscillometric) was used to measure BP at 4 different time points.
Results. Four different BP phenotypes were confirmed based on the magnitude of SBPamp; phenotype-I, both
aortic-to brachial and brachial-to radial SBPamp; phenotype-II, only aortic-to-brachial SBPamp; phenotype-III, only
brachial-to-radial SBPamp; and phenotype-IV, no SBPamp at all. Aortic SBP was significantly higher in phenotypes-
III and IV compared to phenotypes-I and II (p = 0.001). This was not discriminated using a validated cuff BP device
measurement (p = 0.996). Results for the pulse pressure (PP) followed the same pattern.
Conclusion. Distinct BP phenotypes do exist based on SBPamp. A validated cuff BP method failed to discriminate
this. Improving quality of BP measurements in daily practice is a priority. |
