title: Does it make sense to measure only the brachial blood pressure?
abstract: The significant reduction in cardiovascular mortality in the second half of the 20th century, due to an effective battle against high blood pressure, may be considered one of the greatest medical success stories of the past century. However, several epidemiological and clinical studies have recently highlighted that the single acquisition of blood pressure values at brachial level is inadequate to accurately predict the cardiovascular risk of patients with high blood pressure values. Furthermore, some studies suggest the importance of central systolic blood pressure and central pulse pressure (central systolic blood pressure - diastolic blood pressure) as cardiovascular prognostic factors. Central systolic blood pressure and central pulse pressure are able to evaluate the real pressure load imposed on the left ventricle much better than peripheral systolic blood pressure and peripheral pulse pressure. Moreover, the disappearance of the blood pressure amplification phenomenon (i.e. the difference between peripheral and central systolic blood pressure) is a significant predictor of all-cause (including cardiovascular) mortality, independent of age and other standard confounding factors. Thus, the measurement of central arterial pressure provides more precise information on the cardiovascular risk than brachial artery blood pressure measurement.
authors.affiliation: Department of Cardiology, IRCCS Istituto Auxologico Italiano, Milan, Italy. psalvi.md @ gmail.com
authors.forename: Paolo
authors.initials: P
authors.lastname: Salvi
authors.forename: Antonio
authors.initials: A
authors.lastname: Bellasi
authors.forename: Biagio
authors.initials: B
authors.lastname: Di Iorio
mesh_terms: D001011:Aorta; D062186:Arterial Pressure; D001795:Blood Pressure Determination; D001916:Brachial Artery; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D011379:Prognosis