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Oscillometric estimates of aortic blood pressure as an alternative to carotid blood pressure to assess carotid stiffness in humans

Hypertension Research volume 44, pages 888–890 (2021)Cite this article

Carotid artery stiffness is an independent predictor of cardiovascular disease (CVD) [1], the leading cause of morbidity and mortality worldwide. Hence, carotid artery stiffness is a clinically relevant measure for detecting increased CVD risk. However, the ability to assess carotid artery stiffness is technician dependent when using applanation tonometry (AT) to acquire local carotid blood pressure (BP). Oscillometric estimates of aortic BP, where minimal technical skill is required, may be a viable alternative for acquiring carotid BP when assessing carotid artery stiffness. Several techniques, including upper arm (brachial; peripheral) oscillometric cuff-based methods, have been established to assess aortic BP in clinical and research settings using commercially available systems that are both validated and correlated with invasive measures of intra-aortic arterial pressure [2, 3]. The use of oscillometric estimates of aortic BP requires minimal technical experience and may potentially serve as an acceptable alternative to carotid BP, which would enhance the feasibility of assessing carotid artery stiffness and CVD risk. However, there are currently no studies comparing oscillometric estimates of aortic BP with carotid AT-derived BP when assessing carotid artery stiffness. Thus, the aim of this study was to compare oscillometric estimates of aortic BP with carotid AT-derived BP for calculating indices of carotid stiffness (carotid beta stiffness, compliance, and distensibility) in apparently healthy adults across the age spectrum.

Fifty-one (18M/33F; age, 20–74 years; BMI, 18.5–35 kg/m2; systolic blood pressure (SBP), 97–159 mmHg) apparently healthy adults free of cardiovascular or pulmonary disease and cancer and absent of any known cardiovascular medications were examined. Written informed consent was obtained before participation; all study procedures were approved by the Institutional Review Board at Ball State University, and they conformed to the ethical guidelines according to the Declaration of Helsinki. Participants underwent measures of brachial (arm), aortic (central) (SphygmoCor Xcel; pulse wave analysis, PWA), carotid BP (SphygmoCor CvMS E3; AT), and ultrasonography on the right common carotid artery. Cardiovascular Suite (Quipu, Pisa, Italy) was used to analyze carotid artery diameters using specialized edge-detection software. Carotid arterial compliance was calculated as p*dmin*Δd/2ΔP, where p is equal to 3.14, dmin denotes diameter at end-diastole, Δd denotes the overall change in diameter from systole to diastole, with ΔP representing carotid pulse pressure (PP). Carotid distensibility was calculated as 2(Δd/d)/ΔP). The β-stiffness index was calculated as [Ln (carotid SBP/carotid DBP)/(carotid systolic diameter−diastolic diameter)/carotid diastolic diameter)] [4].

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Acknowledgements

The authors would like to thank Dr. James Peterman for his contribution to data analysis. All authors contributed to data interpretation and writing the manuscript and have read and approved the final version of the manuscript.

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  1. Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, USA

    Nicholas A. Carlini, Matthew P. Harber & Bradley S. Fleenor

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Correspondence to Bradley S. Fleenor.

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Carlini, N.A., Harber, M.P. & Fleenor, B.S. Oscillometric estimates of aortic blood pressure as an alternative to carotid blood pressure to assess carotid stiffness in humans. Hypertens Res 44, 888–890 (2021). https://doi.org/10.1038/s41440-021-00637-x

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