title: How to Measure 24-hour Central Blood Pressure and Its Potential Clinical Implications.
abstract: The evaluation of 24-hour central blood pressure (24h cBP) combines the cBP non-invasive assessment with the 24-h ambulatory BP measurement. The major strength of the 24-h cBP evaluation is the ability to assess the degree of circadian changes between central and peripheral BP, namely 24-h BP amplification. This allows an accurate quantification of the degree of spatial and temporal BP variability in each single individual. BP amplification depends from a number of factors, such as the interaction between pressure and flow pulsatile motions, vasomotor tone, arterial tapering and other physiological and anthropometrical determinants. The assessment of 24-h BP amplification, a relatively pressure-independent parameter, may be helpful in better refining the risk of organ damage and future CV events over traditional measures of office and 24-h brachial BP. Currently, only few devices enable the assessment of 24-h cBP. These devices are based on peripheral (brachial or radial) BP waveform detection, and reconstruction of central BP waveform through mathematical models. The estimation of 24-h cBP imputed from multivariate regression equations was also proposed. Clinical data are still scarce and, although suggesting a possible superiority of 24-h cBP over brachial BP in the association with markers of organ damage, they are limited by methodological and technical aspects. There is urgent need of a standardized methodology and rigorous validation protocols for the 24-h cBP assessment. The field of 24-h cBP measurement still requires significant advancements of scientific knowledge before its introduction into clinical practice.
authors.affiliation: Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy. giacomo.pucci@unipg.it.|Struttura Complessa di Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Piazzale Tristano di Joannuccio, 1, 05100, Terni, Italy. giacomo.pucci@unipg.it.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pucci
authors.affiliation: Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy.|Struttura Complessa di Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Piazzale Tristano di Joannuccio, 1, 05100, Terni, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Battista
authors.affiliation: Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy.|Struttura Complessa di Cardiologia, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Crocetti
authors.affiliation: Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy.|Struttura Complessa di Cardiologia, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tilocca
authors.affiliation: Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy.|Struttura Complessa di Cardiologia, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Boschetti
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods* / Q000592:standards; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012044:Regression Analysis; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Ambulatory blood pressure monitoring; Blood pressure amplification; Cardiovascular risk; Central blood pressure; Hypertension; Target organ damage