![]() This explains the difference in pulse wave contour along the arterial tree. At different sites along the arterial tree, the forward and reflected waves meet at different times of a cardiac cycle, forming different blood pressure waveforms. ![]() Along these tubes, blood pressure wave, generated by the heart, transmits to the periphery (forward wave) and is reflected back (reflected/backward wave). The arterial tree is made up of dispensable tubes, which transfers the blood from the heart to the periphery. This chapter discussed current methodologies and devices for CAP estimation. In recent years, there is increasing interest in noninvasive measurement of CAP, evidenced by multiple methods proposed and more and more devices commercialized. Invasive measurement of CAP is considered the “gold standard,” while this method is unsuitable for use in routine screening of large populations or clinical diagnosis. Besides hypertension, CAP also provides insights into the prevention, diagnosis, and treatment of cardiovascular diseases including coronary artery disease, stroke, myocardial infarction, and heart failure. For example, Conduit Artery Function Evaluation (CAFE) which is frequently cited as an example of differential effects of interventions on central and peripheral pressure demonstrated that CAP provides a superior measure of hemodynamic load on the heart and central organs. Second, CAP responds differently to certain drugs from brachial blood pressure. For example, central pressure has been shown to have a closer correlation with surrogate measures of cardiovascular disease. First, recent evidence suggested that CAP may be more strongly related to cardiovascular outcomes. Measurement of CAP can provide more clinically useful information about cardiovascular system beyond brachial blood pressure. Peripheral vasculature and target organs are directly exposed to CAP instead of brachial blood pressure. ĬAP is a better indicator of central hemodynamic stress that is propagated to the peripheral vasculature and target organs, such as the brain and kidneys. However, blood pressures in the proximal aorta and brachial artery are different due to wave reflection, the systolic blood pressure (SBP), and pulse pressure (BP) increase from the aorta to periphery, while diastolic blood pressure (DBP) and mean artery pressure (MAP) just decrease 1–2 mmHg toward the peripheral arteries. For a long time, central aortic pressure (CAP) and brachial artery pressure were considered the same by clinicians. ![]()
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