On the contribution of biomedical engineering and technology to the understanding and the management of arterial hypertension.
There are several reasons why arterial blood pressure, i.e. the pressure within the large arterial vessels, is out of the physical parameters of the human body, one of the most frequently measured. Firstly, arterial blood pressure is a physiologically meaningful parameter, since it represents the driving pressure generated by the heart which maintains blood perfusion in the periphery. Secondly, it is a clinically important parameter: a decline of arterial blood pressure (e.g. in shock) may represent a life-threatening emergency which requires prompt recognition and correction; elevated blood pressure (hypertension) on the other hand is a very common condition, which bears a high risk of cardiovascular mortality and morbidity and can be controlled with appropriate pharmacological means. Thirdly, but not lastly, arterial blood pressure is easily measurable with a fair degree of accuracy by the standard manual sphygmomanometric method and, more recently, by non-invasive automatic techniques. This paper discusses some of the aspects related to arterial blood pressure measurement, in which, in the author's opinion, medical engineering and technology are expected to provide useful advancements. Two major areas will be considered. The first regards the methodologies for arterial blood pressure assessment; the second the identification and acquisition of information additional to blood pressure which would be helpful for a better understanding of blood pressure measurements and/or of risk profiling. For the purpose of this brief paper, we shall mainly use examples and reasonings from our own experience.
Ghione
S
S
CNR Institute of Clinical Physiology, Facoltà di Ingegneria, Pisa, Italy. ghione@nsifc.ifc.cnr.pi.it
Franchi
D
D
Ripoli
A
A
Palagi
G
G
Mezzasalma
L
L
Nardi
G C
GC
Belardinelli
A
A
Berti
S
S
Bedini
R
R
D001698:Biomedical Engineering; D001775:Blood Circulation / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods; D015924:Blood Pressure Monitors / Q000592:standards; D006321:Heart / Q000502:physiology; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D007022:Hypotension / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013677:Medical Laboratory Science; D011786:Quality Control; D012307:Risk Factors; D019722:Sphygmomanometers; D013686:Telemetry / Q000295:instrumentation