Central Blood Pressure Measurement

Overview

What is central blood pressure?

Central blood pressure is the pressure in the aorta, the large artery that sends blood from the heart throughout the body. Experts believe that central blood pressure is more accurate and useful than peripheral blood pressure, because central blood pressure measurement does a better job of predicting if the person will have heart disease or stroke.

What is high blood pressure?

Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, means the pressure in your arteries is above the normal range.

You usually can’t feel high blood pressure. Many people who have high blood pressure don't know they have it. In most cases, no one knows what causes it. People who have untreated high blood pressure are at greater risk for stroke, enlarged heart, heart failure, peripheral vascular disease, heart attack and kidney disease/failure.

Why is central blood pressure measurement important?

As people age, their blood vessels lose some flexibility and become stiffer, which makes it harder for the heart to pump. This is known as arterial stiffness. Measuring the central blood pressure can give the doctor an accurate picture of the degree of arterial stiffness, as well as the likelihood that the person will have a heart attack or stroke.

Test Details

How is blood pressure measured and recorded?

Your healthcare provider can check your blood pressure with a special meter and an inflatable cuff around the upper arm. Blood pressure is written as two numbers, such as 118/72. The first number is the systolic pressure. This is the pressure in the arteries when the heart beats and fills them with blood. The second number is the diastolic pressure. This is the pressure in the arteries when the heart rests between beats. Blood pressure taken at the arm is called “peripheral blood pressure.”

How is central blood pressure measured?

One method of measuring central blood pressure is with a tonometer, a small instrument shaped like a wand. The tonometer is placed on the skin over the brachial artery in the arm to measure the pulse. By taking the pulse and the peripheral blood pressure measurements together, the central blood pressure can be calculated with a mathematical formula called a generalized transfer function. Instead of a tonometer, a regular blood pressure cuff attached to a specialized device can also be used to get the pulse waveform and obtain central blood pressure measurements. The technique to obtain central blood pressures is completely non-invasive.

Results and Follow-Up

How is high central blood pressure treated?

High blood pressure can be treated with a number of different drugs, including:

  • Diuretics (water pills).
  • Beta blockers.
  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Calcium channel blockers.
  • Angiotensin receptor blockers.

Several studies have shown that the medications that lower central blood pressure most effectively are:

  • Calcium channel blockers.
  • ACE inhibitors.
  • Angiotensin receptor blockers.

Last reviewed by a Cleveland Clinic medical professional on 08/14/2020.

References

  • Townsend RR, Rosendorff C, Nichols WW, et al. American Society of Hypertension 10(5) (2016) 467–468 Society of Hypertension position paper: central blood pressure waveforms in health and disease. J Am Soc Hypertens 2016;10(1):22–33.
  • Miyashita H. Curr Hypertens Rev. 2012 May; 8(2): 80–90. Accessed 11/11/2020.Clinical assessment of central blood pressure. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409361/)
  • Agabiti-Rosei E, Mancia G, O’Rourke M, et al. Hypertension. 2007;50:154-160. Accessed 11/11/2020.Central blood pressure measurements and antihypertensive therapy: A consensus document. (https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.107.090068)
  • American College of Cardiology. Accessed 11/11/2020.Blood Pressure Measurement: Is it time to leave the Korotkoff method behind? (http://www.acc.org/latest-in-cardiology/articles/2015/05/19/13/08/blood-pressure-measurement-is-it-time-to-leave-the-korotkoff-method-behind)

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