title: Traditional Chinese medicine wrist pulse-taking is associated with pulse waveform analysis and hemodynamics in hypertension.
abstract: BACKGROUND
  Pulse wave analysis (PWA) quantifies the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis (PIA) is a subjective examination in traditional Chinese medicine.
  
  
  OBJECTIVE
  This study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension.
  
  
  METHODS
  This observational, cross-sectional study enrolled 45 patients (26 men, (55.2 ± 10.3) years, systolic blood pressure (155 ± 28) mmHg, diastolic blood pressure (93 ± 17) mmHg) for assessment of clinical and laboratorial data.
  
  
  METHODS
  Primary outcomes comprised: pattern differentiation based on an automated method; PIA at the radial artery using the 'simultaneous pressing' method for identification of factors such as strength (strong/weak), depth (superficial/deep), and speed (fast/moderate/slow); and PWA at the same artery using a noninvasive system.
  
  
  RESULTS
  Significant multivariate main effects were observed for depth (λ=0.648, F5,29 =3.149, P=0.022, η(2) =0.352), strength (λ=0.608, F5,29 =3.736, P=0.010, η(2) =0.392), and speed (λ=0.535, F5,29 =5.302, P=0.002, η(2) =0.465). General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mmHg and systolic blood pressure ≥ 149.5 mmHg, whereas a superficial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s.
  
  
  CONCLUSIONS
  Associations were explained by LaPlace's law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.
authors.affiliation: Postgraduate Program of Rehabilitation Science, Augusto Motta University Center, 21041-010, Rio de Janeiro, RJ, Brazil.
authors.forename: Nathalia Gomes Ribeiro
authors.initials: NG
authors.lastname: Moura
authors.affiliation: Division of Arterial Hypertension, National Institute of Cardiology, 22240-002, Rio de Janeiro, RJ, Brazil.
authors.forename: Ivan
authors.initials: I
authors.lastname: Cordovil
authors.affiliation: Postgraduate Program of Rehabilitation Science, Augusto Motta University Center, 21041-010, Rio de Janeiro, RJ, Brazil.|Department of Physical Therapy, Salgado de Oliveira University, 24030-060, Niterói, RJ, Brazil.
authors.forename: Arthur de Sá
authors.initials: Ade S
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D063177:Pulse Wave Analysis; D014953:Wrist