Brachial-to-radial SBP amplification: implications of age and estimated central blood pressure from radial tonometry

Picone, Dean S., Climie, Rachel E.D., Ahuja, Kiran D.K., Keske, Michelle A. and Sharman, James E. 2015, Brachial-to-radial SBP amplification: implications of age and estimated central blood pressure from radial tonometry, Journal of hypertension, vol. 33, no. 9, pp. 1876-1883, doi: 10.1097/HJH.0000000000000637.

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Title Brachial-to-radial SBP amplification: implications of age and estimated central blood pressure from radial tonometry
Author(s) Picone, Dean S.
Climie, Rachel E.D.
Ahuja, Kiran D.K.
Keske, Michelle A.ORCID iD for Keske, Michelle A.
Sharman, James E.
Journal name Journal of hypertension
Volume number 33
Issue number 9
Start page 1876
End page 1883
Total pages 8
Publisher Wolters Kluwer Health
Place of publication Philadelphia, Pa.
Publication date 2015-09
ISSN 1473-5598
Keyword(s) Adult
Age Factors
Blood Pressure
Blood Pressure Determination
Brachial Artery
Heart Rate
Middle Aged
Radial Artery
Young Adult
blood pressure/physiology
vascular stiffness
Science & Technology
Life Sciences & Biomedicine
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Summary OBJECTIVES: The reference standard for noninvasive estimation of central blood pressure (BP) is radial tonometry calibrated using brachial SBP and DBP. Brachial-to-radial-SBP amplification (B-R-SBPAmp) may introduce error into central BP estimation, but the magnitude of such amplification is uncertain. This study aimed to determine the magnitude and effect of ageing on B-R-SBPAmp; the effect of B-R-SBPAmp on radial tonometry estimated central SBP; and correlates of B-R-SBPAmp. METHODS: Forty young (28 ± 5 years) and 20 older (60 ± 8 years) healthy participants underwent brachial and radial artery ultrasound to identify SBP from the first Doppler flow inflection during BP cuff deflation (first Korotkoff sound). Impedance cardiography, ultrasound, tonometry and anthropometric data were collected to explore B-R-SBPAmp correlates. RESULTS: Radial SBP was significantly higher than brachial SBP in younger (118 ± 12 versus 110 ± 10  mmHg; P < 0.001) and older (135 ± 12 versus 121 ± 11  mmHg; P < 0.001) participants. The magnitude of B-R-SBPAmp (radial minus brachial SBP) was higher in older than younger participants (14 ± 7 versus 8 ± 7  mmHg; P = 0.002), independent of sex and heart rate. Estimated central SBP was higher in both age groups when radial waveforms were recalibrated using radial (versus brachial) SBP (P < 0.001). The central SBP change relative to B-R-SBPAmp was associated with augmentation index (r = 0.739, P < 0.001), independent of age, sex and heart rate. Age, male sex and high-density lipoprotein each positively related to B-R-SBPAmp in multiple regression analysis (P < 0.05). CONCLUSION: Major B-R-SBPAmp occurs in healthy people and is higher with increasing age. Furthermore, B-R-SBPAmp contributes to underestimation of radial tonometry derived central SBP.
Language eng
DOI 10.1097/HJH.0000000000000637
Field of Research 110299 Cardiorespiratory Medicine and Haematology not elsewhere classified
1103 Clinical Sciences
1102 Cardiovascular Medicine And Haematology
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Grant ID NHMRC 569519
Copyright notice ©2015, Wolters Kluwer Health
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