Artery Research

Volume 12, Issue C, December 2015, Pages 41 - 41

2.3 TESTING RIVA-ROCCI’S BASIC ASSUMPTIONS BY SYSTEMATIC REVIEW AND META-ANALYSIS TO DETERMINE THE TRUE DIFFERENCE BETWEEN AORTIC AND BRACHIAL INVASIVE BLOOD PRESSURE

Authors
Dean Picone*, Petr Otahal, Martin Schultz, James Sharman
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
Available Online 23 November 2015.
DOI
10.1016/j.artres.2015.10.010How to use a DOI?
Abstract

Background: The Riva-Rocci brachial blood pressure (BP) method purported to measure aortic BP, and this remains the cornerstone thesis of clinical BP measurement. However, few studies have confirmed this thesis with direct BP measurements. This study aimed to determine the true differences in aortic and brachial BP by systematic review and meta-analysis of invasive (intra-arterial) data.

Methods: Five online databases and several offline techniques were used to search for studies that reported simultaneous or sequentially recorded intra-arterial aortic and brachial BP. Differences in systolic BP (SBP) and diastolic BP (DBP) were calculated as brachial minus aortic values.

Results: Data from 12 studies (from 1956 to 2013), totalling 399 participants (aged 57.3 [95% CI: 52.2, 62.4] years, 76.9% male) met inclusion criteria. Brachial SBP was significantly higher than aortic SBP (pooled SBP difference estimate = 7.99 [95% CI: 5.30, 10.7] mmHg, p<0.001; I2 = 93.3%). However, there was only a minimal decrease in DBP between the aorta and brachial artery (pooled DBP difference estimate = −0.67 [95% CI: −1.67, 0.32] mmHg, p = 0.18; I2 = 79.7%). Heterogeneity in SBP differences between studies was modestly explained by age (R2 = 5.7%), but not by sex, measurement method (simultaneous or sequential) or type of catheter (fluid-filled or micromanometer [R2 = 0% all]).

Conclusion: Although only minimal difference in DBP, brachial SBP is significantly higher than aortic SBP, with substantial variability in the magnitude of SBP difference. This questions the Riva-Rocci assumption of brachial BP being representative of aortic BP, and could have accuracy implications for BP assessment using the brachial cuff method.

Open Access
This is an open access article distributed under the CC BY-NC license.

Journal
Artery Research
Volume-Issue
12 - C
Pages
41 - 41
Publication Date
2015/11/23
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2015.10.010How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Dean Picone*
AU  - Petr Otahal
AU  - Martin Schultz
AU  - James Sharman
PY  - 2015
DA  - 2015/11/23
TI  - 2.3 TESTING RIVA-ROCCI’S BASIC ASSUMPTIONS BY SYSTEMATIC REVIEW AND META-ANALYSIS TO DETERMINE THE TRUE DIFFERENCE BETWEEN AORTIC AND BRACHIAL INVASIVE BLOOD PRESSURE
JO  - Artery Research
SP  - 41
EP  - 41
VL  - 12
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2015.10.010
DO  - 10.1016/j.artres.2015.10.010
ID  - Picone*2015
ER  -