Putting a pen to the pulse to measure central BP

Researchers from the University of Queensland are using technology developed by Australian company AtCor Medical in a study looking at whether lowering central blood pressure can reduce cardiovascular disease risk in people with hypertension.

The technology, called SphygmoCor, measures central blood pressure at the wrist, rather than the traditional brachial measurement using a blood pressure cuff on the upper arm.

It is being used in a number of clinical trials around the world, including the UQ research, which recently won an NHMRC grant worth $1.4 million.

Principal investigators Jim Sharman and Michael Stowasser from the UQ School of Medicine are currently running the Targeted LOWering of Central Blood Pressure (LOW CBP) randomised controlled trial, which is looking at whether targeted lowering of central blood pressure will improve CVD risk above and beyond conventional brachial blood pressure.

The team recently discovered that the use of routine low-dose spironolactone, a cheap and well-tolerated antihypertensive, can lower central blood pressure.

The researchers say that even in populations with normal brachial blood pressure, there is still considerable risk for CVD, which their research has found is often due to persistently elevated central blood pressure.

To test whether targeting central blood pressure can reduce CVD risk, they are using AtCor's SphygmoCor technology, a non-invasive way of accurately measuring central blood pressure.

“Preliminary studies have indicated that the standard inflated arm cuff, a crude method that is over 100 years old, may not necessarily be the best way to measure blood pressure on those who have hypertension,” Dr Sharman said in a statement.

“In recent years, non-invasive techniques have been developed to give a more accurate estimate of blood pressure that the organs are exposed to, and central blood pressure.

“The new method measures central blood pressure from the arterial pulse at the wrist using a pen-like device that has a pressure transducer at the tip. This is placed lightly on the pulse at the wrist and a mathematical formula is then used to synthesise central blood pressure.

“The method is quick, reliable and provides important information on blood pressure that is above and beyond that using the old upper arm cuff method.”

The researchers are currently recruiting men and women from Brisbane aged between 18 and 70 who have been diagnosed with hypertension. Patients will be asked to visit the Princess Alexandra Hospital every six months.

“We expect that evidence from this new trial will ultimately lead to a paradigm shift in the approach to treating patients with hypertension,” Dr Sharman said.

“That is, central blood pressure will be considered a more important therapeutic target than conventional blood pressure measured at the upper arm.”

Posted in Australian eHealth

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