Central Vs Peripheral Blood Pressure

Blood pressure (BP) is a common physiological measurement taken by health professionals, which is an easy, quick and non-invasive indication of the pressure that the blood is exerting on the heart and circulatory system. For over 100 years we have measured blood pressure (BP) from the upper arm, termed peripheral BP, which doctors subsequently use to diagnose high BP or hypertension.

Central BP is the pressure in the aorta, which is the large artery into which the heart pumps and is considered a better indicator of the pressure the heart and other vital organs experience. Furthermore, central BP has been shown to be a better predictor of vascular disease when compared to peripheral BP. However, peripheral BP is used to guide decisions on high BP treatment/medication, which affects around 30% of Australian adults.

A current, ongoing study from 2013, led by James Sharman at the Menzies Institute of Tasmania, uses a pen-like device on the wrist to accurately measure the central BP of people who suffer from hypertension and take medication for this. It has recently been determined that significantly less medication was needed to achieve healthy blood pressure levels, when treatment decisions were based on central BP. Amazingly, 16% of patients came off medication altogether. These are really important findings because blood pressure medications can produce unwanted side effects. However this can be reduced through a lower dose of medication.

So why don’t we measure central BP instead of peripheral BP? Research has shown positive signs for measuring central BP, however, there is still a lot more scientific research required to validate its use. Furthermore, the cost of a device to measure central BP is still very expensive when compared to peripheral BP.

If you have high blood pressure, there are steps to reduce it without using medication. These include:

1. Cardiovascular exercise for at least 30 minutes a day, 3-4 times per week (e.g. jogging, walking, cycling, swimming).

2. Reducing the amount of sodium you eat (less than 2,300 mg per day).

3. Cut back on the caffeine (limit to 2 cups per day).

4. Limit your alcohol consumption. Alcohol can also reduce the effect of blood pressure medications !

5. Lower your stress levels. Think about what causes you stress, and try to eliminate it.

It is important to remember that high blood pressure usually won’t produce any symptoms. It is important to get a regular check up from your local doctor. With any luck you may see a new blood pressure measurement device the next time you go for your check up!

References:

1. JE Sharman & S Laurent; 2013, Central blood pressure in the management of hypertension: soon reaching the goal?, Journal of Human Hypertension 27, 405-411

2. JE Sharman, TH Marwick, D Gilroy, P Otahal, WP Abhayarantna, M Stowasser; 2013, Randomized Trial of Guiding Hypertension Management Using Central Aortic Blood Pressure Compared With Best-Practice Care, Principal Findings of the BP GUIDE Study; Hypertension, 62, 1138 – 1145

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