Central blood pressure and pulse wave velocity

custo diagnostic news 

Central Blood Pressure & Pulse Wave Velocity 

custo med GmbH 

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Phone: +49 - 89 - 710 980 0 

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Email: peter.rumm@customed.de 

stefanie.peschl@customed.de 

Authors: 

Peter Rumm & Stefanie Peschl 

Central blood pressure and pulse wave velocity 

with spot measurement and ABPM 

________________________________________________________________________ 

Table of Contents 

Abstract ................................................................................................................................................................ 2 

Introduction .......................................................................................................................................................... 2 

Pulse wave and augmentation ............................................................................................................................. 3 

Pulse wave velocity and central blood pressure ................................................................................................... 3 

Vascular age ......................................................................................................................................................... 4 

Correlation between brachial and central blood pressure ................................................................................... 4 

The validated analysing algorithm Antares .......................................................................................................... 5 

Diagnostic importance of central blood pressure ................................................................................................. 5 

Implementation in custo diagnostic ..................................................................................................................... 6 

Screen 310 – the recorder for determining central blood pressure ...................................................................... 6 

The software module central blood pressure ....................................................................................................... 7 

The spot measurement (single measurement) ..................................................................................................... 7 

ABPM .................................................................................................................................................................... 8 

Conclusion ............................................................................................................................................................ 9 

Literature ............................................................................................................................................................ 10 

List of abbreviations ........................................................................................................................................... 11 

Table of figures ................................................................................................................................................... 11 

© custo med GmbH custo diagnostic news – CDN-009- Central Blood Pressure & PWV-23-06-2020-DK- 1889-EN-PES_RUM-001.doc 

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Abstract 

Very early in the history of blood pressure measurement the focus was on the determination of central aortic 

blood pressure. In particular later research shows that the central blood pressure is a decisive indicator in 

assessing the cardiovascular risk. In addition, this indicator is important for assessing with all certainty whether 

there is hypertension in a patient or if an anti-hypertensive treatment is efficient. The blood pressure software 

custo screen which integrates the analysing algorithm Antares (Redwave Medical GmbH) now enables to 

determine pulse wave velocity (PWV) by using the blood pressure recorder custo screen 310, both in a single 

blood pressure measurement (spot measurement) and in ambulatory blood pressure monitoring (ABPM). 

Antares was clinically validated within a multi-centric study. Thus, the blood pressure analysis at custo med is 

complemented in medically adequate form, enabling the physician to assess the cardiovascular risk of a 

patient optimally and to comply with the recommendations of the current guideline of arterial hypertension. 

Thus, the central blood pressure can be exactly determined in the established and familiar brachial cuff 

measurement at the upper arm, in an approach that is familiar to clinicians, accepted by patients and 

accessible as a wide-spread method. In other words: this modern blood pressure technology can meet the 

original purpose of the measurement of central aortic blood pressure, as it was intended more than 100 years 

ago. 

The PWV has an additional prognostic significance for cardiovascular events going beyond the classical 

cardiovascular risk factors. Although it is not possible to directly conclude from the diagnosis of increased 

arterial stiffness that there is atherosclerosis or a coronary heart disease, a PWV exceeding 10 m/s should 

nevertheless be considered as pathological. When choosing devices, it is important that a manufacturerindependent, 

standardized validation as well as an additive valence proved in epidemiologic and prognostic 

studies exist – which is the case for the blood pressure recorder custo screen 310 and the software module 

custo screen with Antares. 

Introduction 

The original purpose of determining brachial blood pressure more than 100 years ago was the evaluation of 

central (aortic) blood pressure. In the original reports of Riva-Rocci from 1896 about the use of a cuff device for 

measuring blood pressure, the technology was described as measurement of pressure "[…] either in the aorta 

itself […]" or "[…] at a point quite close to the aorta […]" [1]. 

It is therefore logical that today the central blood pressure gains in importance in relation to the established 

brachial blood pressure measured at the arm [2]. Although the brachial measurement over 24h at the upper 

arm is still the gold standard for blood pressure measurement, it is clear in the meantime that health 

professionals should keep an eye on "[…] the whole pressure curve and not only on the two extreme values 

[…]" [3]. Today, the blood pressure curve is experiencing a renaissance thanks to modern pulse wave analysis. 

A high blood pressure is an important cardiovascular risk factor. However, it is also known that in humans with 

a comparable brachial blood pressure, big differences may occur in the central systolic blood pressure – partly 

more than 30 mmHg [3]. Experience made in anti-hypertensive therapy has made clear that blood pressure 

lowering drugs may affect the central blood pressure differently than the brachial BP [4]. 

If the central blood pressure of a patient is known, the following statements can be made: 

a validated cardiovascular risk biomarker exists [5] 

a significantly improved prediction of future cardiovascular events is possible, going beyond the 

validity of brachial blood pressure and other cardiovascular risk factors [6] 

there is a higher diagnostic accuracy compared to brachial blood pressure 

an improved patient management is possible, compared to the care that is exclusively oriented 

towards brachial blood pressure. 

With the option "central blood pressure" it is possible to complement the classical blood pressure 

measurement by this important parameter. Based on the current ESH recommendations [7], the module 

complements the software platform custo diagnostic in the field of blood pressure analysis and provides - in 

addition to highest measurement accuracy - a validated method without requiring additional examinations. 


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There are no changes in the classical measurement process of ABPM because the determination of central 

blood pressure goes hand in hand with the determination of classical blood pressure. 

In the following sections, more details about the individual parameters such as pulse wave, pulse wave velocity 

and vascular age are discussed. 

Pulse wave and augmentation 

The most important task of the aorta is to distribute blood from the heart to the body. To make sure that the 

blood does not only flow in the ejection phase but also in the relaxation phase of the heart, a large part of the 

energy produced by the heart muscle is saved in the 

elastic fibres of the aorta. Therefore, the aorta acts 

like a "second heart" passing the blood to the 

organs. This function of the aorta, the energy uptake 

in the ejection phase and energy transfer in the 

relaxation phase, is called Windkessel effect. 

As the arterial diameter decreases from the centre of 

the body to the peripheral part of the body, the 

pressure increases due to physical reasons. This is 

why the peripheral (brachial) systolic blood pressure 

is normally higher than the central blood pressure. 

The pressure progression in the large arteries 

strongly depend on age (s. Fig. 1). In young humans 

an amplification (increase of blood pressure due to 

the different arterial diameter) in the periphery and 

therefore a big difference between central and 

Figure 1: Blood pressure and pulse wave in dependence of age [3] brachial blood pressure can be normal. At 

higher ages, the increase of blood pressure 

amplitude is usually due to augmentation, which means the over-increase of the systolic pressure wave caused 

by the reflected part still during the ejection phase of the heart, while the diastolic aortic pressure decreases. 

With increasing arterial stiffness, the time until the reflected pulse wave arrives at the heart shortens and thus 

the systolic, aortic pressure increases. The conventional 

measurement at the arm artery targeting the brachial blood pressure exclusively, overestimates the central 

blood pressure in young humans with elastic vessels and underestimates it in elderly patients with arterial 

stiffness and atherosclerosis [8]. The only method for a non-invasive differentiation is the pulse wave analysis. 

Consequently, it is not possible to draw conclusions about the central blood pressure merely on the basis of 

the peripheral, brachial blood pressure. The determination of pulse wave velocity in m/s (meter per second) is 

an important parameter of arterial elasticity and a predictor of cardiovascular events. The Munich-based 

physiologist Otto Frank described pulse wave velocity in dogs with 7 m/s for the first time in 1904. He kept an 

eye on the whole pressure curve as well. [3]. 

Pulse wave velocity and central blood pressure 

The PWV specifies at which speed the pressure wave of blood moves in the arteries after a cardiac action. 

Arterial stiffness can be quantified with the PWV. With increasing stiffness of the aorta, the PWV becomes 

higher. The prognostic importance of PWV is widely proven. The central aortic pressure (central systolic 

pressure) is a more exact measure for the actual hemodynamic stress of the heart than the peripheral blood 

pressure. Rising arterial stiffness inevitably leads to an increase of both PWV and central blood pressure values. 

With stiffer vessels, the PWV is higher and there is more stress on the end organs, for the central aortic pressure 

affects them directly. The blood flow changes with increasing arterial stiffness, with the originally laminar, 

consistent vascular blood circulation changing to a pulsatile flow. This means stress for the susceptible organs 

which highly depend on a laminar microcirculation. These are in particular the heart, the brain, the kidneys and 

the eyes. This is why hypertensive organ damages correlate better with the central than with the brachial blood 

pressure [9]. 


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Beside other cardiovascular risk factors, the PWV provides additional significant information about 

cardiovascular events. An increase of PWV by 1 m/s is associated with an increase of the cardiovascular risk by 

up to 15 %. It is a direct measure for arterial stiffness and reflects clinically significant, pathophysiologic 

changes. It correlates better with cardiovascular events and mortality than the peripheral blood pressure [10]. 

The standard value for PWV depends on a person's age. The PWV in healthy humans with normal blood 

pressure ranges between 4 and 9 m/s, depending on age. However, a PWV exceeding 10 m/s can be considered 

as pathologic [11]. 

Vascular age 

Due to the constant loss of elastic fibres, the aorta belongs to the human organs that are subject to a very early 

aging process. Increasing calcification is significant for the loss of elasticity due to which the Windkessel 

function deteriorates as well. If the elasticity loss becomes effective, the aorta cannot extend enough in the 

ejection phase and as a consequence the systolic blood pressure rises. The diastolic blood pressure in contrast 

decreases further as blood cannot flow sufficiently anymore due to missing elasticity in the relaxation phase. 

This process of vascular aging is called stiffening, accompanied by high systolic and low diastolic blood 

pressure values. The isolated systolic hypertension, by far the most frequent form of hypertension in higher 

age, is based on the pathophysiologic process of vascular aging. A stiffening aorta develops as a result of 

conversion processes in the aortic vessel wall. This leads to fragmentations of elastin, incorporation of collagen 

and calcification. The vessel becomes stiffer and the reflected pulse wave relocates more and more towards 

the systole. 

The most important measure for aortic elasticity or stiffness is the PWV: the stiffer the artery wall, the higher the 

PWV. The PWV enables to regard a patient's stiffness of vessels and compare it to that of healthy people of the 

same age. This is a way to determine by how many years the vessels diverge from the chronological age. A 

slightly higher vascular age corresponds to a normal aging process up to a certain degree. It will become 

critical if the aorta is significantly older and thus deviates considerably from the chronological age. This 

phenomenon of premature aging of arteries is called "Early Vascular Aging" (EVA) [11]. Thus, the examination of 

vascular age by means of PWV has the advantage that the vascular age of a person can be determined – 

independently of the chronological age. 

Correlation between brachial and central blood pressure 

If both the brachial and the central blood pressure are in 

the normotensive range, a physiological arterial elasticity 

can be assumed. If isolated systolic hypertension is existent 

in elderly people or in young people, the knowledge of the 

central blood pressure is indispensable to differentiate 

between a harmless juvenile systolic hypertension with 

increased vessel elasticity and a pathologic systolic 

hypertension with increased arterial stiffness. In the first 

case, it is a (harmless) amplification, in the second case it is 

a (pathologic) augmentation in which the systolic pressure 

wave results in an extensive increase of systolic blood 

pressure (brachial and central) due to the reflected pulse 

wave. This is caused by increased arterial resistance. 

A masked aortic hypertension is defined as hypertension 

form with normal blood pressure values in practice or 

hospital and increased values in daily routine which 

normally come to light with ambulatory blood pressure 

monitoring (ABDM) or self-measurement. 

Figure 2: Correlation between central and brachial 

blood pressure [3] 


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Then, an increased cardiovascular risk and typical hypertensive organ damages are already existent. The 

reversible elasticity is of crucial importance for the functional coupling between the heart and the vascular 

system [3]. 

The validated analysing algorithm Antares 

For identifying aortic stiffness, the measurement of PWV between the carotid and femoral arteries is 

considered as gold standard. PWV and central systolic pressure can be determined indirectly in the course of a 

tonometric or oscillometric blood pressure measurement. Ideally, the measurement of blood pressure and 

PWV should be possible all in one. The measurement accuracy of these indirect methods must be checked and 

validated against an invasive catheterization. Beside the parameters of arterial stiffness, additional information 

as to peripheral resistance and stroke volume may be helpful as they might support therapeutic decision 

making [9]. 

The ideal solution would be to obtain the central blood pressure by means of a suitable analysing algorithm 

within the common brachial cuff measurement because it still complies with the gold standard. It is applied on 

a wide scale, is known in clinical practice and acceptable for patients [10]. Here, the central blood pressure is 

calculated via a transfer function and an (existing) augmentation is directly derived. 

The analysing algorithm Antares is a software module from Redwave Medical GmbH, with which a pulse wave 

analysis (PWA) can be carried out. Within the framework of this PWA, the parameters central (aortic) blood 

pressure and pulse wave velocity are determined. The algorithm was validated in a multi-centric study in which 

the central blood pressure measured invasively via a cardiac catheter was compared with the results of the 

cuff-based blood pressure measurement with subsequent calculation of the central blood pressure [12]. In 

total, 191 patients were admitted who had to undergo a cardiac catheter examination. From these, 145 

patients could be further analysed. The invasive recordings of the central blood pressure were compared with 

the central blood pressure values determined simultaneously and in non-invasive manner. Those lastmentioned 

ones were calculated by using the Antares algorithm and a custo screen recorder. 

The mean difference between the invasive and non-invasive systolic central blood pressure was 0.71 mmHg, 

with a standard deviation of 5.95 mmHg. Thus, the requirements of the validation protocols of the ARTERY 

Society, ESH, BHS and AAMI are fully met. 

On the basis of this knowledge, the validated Antares algorithm has been integrated into the blood pressure 

analysing software custo screen. In combination with the blood pressure recorder custo screen 310 it is now 

possible to conduct a pulse wave analysis easily and everywhere. 

Diagnostic importance of central blood pressure 

Regarding the benefit of central blood pressure, the recommendations of the European Societies for 

Hypertension and Cardiology report as follows: "Not to treat young patients with systolic hypertension found in 

conventional measurement per arm artery and measure the pulse wave velocity as biomarker of the vascular 

function" [3]. Due to the pulse wave analysis it is possible to determine the physiologic parameters central 

blood pressure and pulse wave velocity [13]. The natural aging process of humans makes the blood pressure 

rise and it may reach a similar level as the peripheral blood pressure [14]. A number of studies showed that the 

central blood pressure in hypertension patients correlates stronger with end organ damages than the 

peripheral blood pressure. This means that especially young patients with low/normal central blood pressure 

do not need treatment despite showing increased peripheral blood pressure. Thus, over-treatment can be 

avoided [15]. 

While analysing data of the Framingham study, the correlation between blood pressure and arterial stiffness 

was examined over a period of 7 years in approx. 1,800 subjects. It was concluded that increased arterial 

stiffness correlates significantly with the occurrence of hypertensive blood pressure values. Conversely 

however, the increased peripheral blood pressure values alone do not prove to be very helpful for predicting a 

rising arterial stiffness in later stages [11]. 

Also, with regard to the drug therapy, the central blood pressure proves to be a diagnostically relevant 

indicator. The CAFE study compared how different drugs (Amlodipin vs. Atenolol) which cause a comparable, 

peripheral blood pressure lowering, affect the central blood pressure and subsequently mortality and 


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morbidity. It showed that the Amlodipin treatment could reduce the central blood pressure more efficiently 

than Atenolol and has therefore a better cardiovascular outcome regarding morbidity and mortality [16]. 

The shape of the pulse wave ("shape") and the PWV, depending decisively on arterial stiffness, are relevant 

parameters for the assessment of central blood pressure. Pulse wave velocity and central blood pressure are 

predictive parameters for myocardial infarction and stroke, as they enable to view the state of the vessels 

indirectly. Consequently, they are superior to a mere risk identification based on the known factors such as 

peripheral blood pressure, age or cholesterol. 

An increased central blood pressure means an increase in cardiac afterload which reduces the diastolic 

coronary flow and thus the myocardial microcirculation. As a consequence, other organs such as kidneys and 

brain may be damaged as well. [9]. 

Due to the independent prognostic value of arterial stiffness for cardiovascular events such as ischemic heart 

disease, stroke and renal insufficiency, arterial stiffness is a risk marker for atherosclerotic vessel diseases of a 

patient [11]. 

The prognostic value of arterial PWV surpasses classical risk scores such as for example the Framingham risk 

score and can be used for risk stratification with other underlying risk factors (hyperlipidemia, diabetes etc.) as 

well. The PWV-based risk evaluation is superior to a risk assessment performed according to "known" risk 

factors, as it is done in the Framingham risk score with gender, age, blood pressure, cholesterol, diabetes and 

smoking status. The combination of both however, arterial stiffness and conventional risk factors, has brought 

a very realistic prediction as to the occurrence of cardiovascular events, and that is exactly what modern 

cardiovascular diagnostics requires [17]. 

However, it is doubtful whether for elderly patients (>80 years) the prognostic significance of the PWV will not 

reach its limit due to the probably high calcification and associated vessel damages. 

For practical, clinical considerations the correlations between arterial stiffness (PWV), blood pressure and age 

are highly interesting, not least because a PWV exceeding 10 m/s has been adopted as additional end organ 

damage in the guidelines of the European hypertension league [7]. 

A recently published study (Project ASINPHAR@2action) carried out in pharmacies of 11 Portuguese 

communities, aims at raising awareness of arterial stiffening and early vascular aging (EVA) by means of blood 

pressure determination. The central and peripheral blood pressure was measured oscillometrically. The 

proportion of study participants with increased arterial stiffening was around 20%. The model that best fitted 

for arterial stiffening included age, gender, central aortic blood pressure, visceral fat, HDL cholesterol, 

augmentation index, total arterial resistance, hypertension and diabetes. The measurements of the arterial 

function in community pharmacies is to provide a basis for the operationalisation of the sub-clinical screening 

of target organ damages and thus serve as a strategy for improving the supervision of the cardiovascular risk 

and for promoting treatment adherence [18]. 

Implementation in custo diagnostic 

Screen 310 – the recorder for determining central blood pressure 

For determining the central blood pressure and pulse wave velocity, it is required to process the entire scope of 

all oscillations occurring in a blood pressure measurement. This required extensions for the blood pressure 

recorders regarding data saving and processing, which have been implemented in the new blood pressure 

recorder custo screen 310. custo screen 310 differs from its predecessor custo screen 300 in various hardware 

extensions (memory, processor) and a special firmware. The determination of central blood pressure in custo 

diagnostic is only possible with a custo screen 310. However, the examination procedure does not differ from 

the so-far handling regarding recorder start and recorder readout. When downloading a blood pressure 

examination carried out with custo screen 310, the central blood pressure is determined, the PWV is calculated 

and the results are displayed in the software. 


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The software module central blood pressure 

The spot measurement (single measurement) 

The spot measurement is a singular blood pressure measurement which delivers the central and brachial 

blood pressure, the pulse wave, pulse wave velocity and the vascular age. By means of the spot measurement 

the cardiovascular risk can be assessed on the basis of pulse wave velocity. If the result of a spot measurement 

is unclear or borderline, it can be repeated as often as required. All measurements are shown in chronological 

order (see also Fig. 3a). 

Figure 3a: Spot measurement with view of pulse wave and specification of brachial and central blood pressure values, 

pulse wave velocity as well as vascular age 

They can be confirmed, printed or deleted. If there is a reasonable suspicion of hypertension, for example due 

to suspicious PWV, a 24h-recording can be arranged to 

clarify it. The pulse waves can be displayed individually, 

according to the currently selected measurement (s. Fig. 

3a), or for all performed measurements of a patient (s. Fig. 

3b). When carrying out a spot measurement, it is 

recommended to let the patient calm down before the 

measurement starts because notably psychological stress 

situations may lead to untypically high blood pressure 

values [19]. If high blood pressure values are obtained in 

the initial measurement, a further measurement is 

recommended after a short waiting period. Fig. 3a shows 

that after the waiting period, the patient achieves lower 

blood pressure values than at the beginning. The 

variability of pulse wave velocity and vascular age is 

visible as well. A further repeated measurement 

Figure 3b: Spot measurements: View of all pulse waves 

confirms the second measurement and shows that the 

patient's blood pressure values are in the standard 

range. However, an ABPM could give information about how often and how long the patient is exposed to 

stressful situations, to clarify for example a masked hypertension. 


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ABPM 

Beside the brachial, systolic and diastolic blood pressure values, in ABPM with custo screen 310 the central 

blood pressure values are also determined for each point in time of the measurement. Furthermore, the 

analysis provides information about pulse wave velocity and vascular age. In addition, the corresponding pulse 

wave is displayed for each measurement. The respective day and night threshold values can be fixed and faded 

in both for the brachial and the central blood pressure. 

Figure 4a: ABPM - brachial and central blood pressure values with PWV, vascular age and all measured pulse waves 

In the summary table, the average values of the 

determined parameters are listed for the whole 

measurement period and are subdivided in day and 

night. The line description of the individual 

parameters on the left border of the table at the same 

time serves as a button in order to show or hide the 

graphic view of values - simply per mouse click on the 

desired parameter. 

On the lower right border of the table, the calculated 

vascular age of the patient is specified, essentially 

calculated on the basis of pulse wave analyses of the 

single measurements (Fig. 4a). 

In the initial analysis of an examination, two pulse 

waves are automatically marked for the printout 

which are representative for the day and night 

average. The advantage is that the user gets at least 

two representative pulse waves as printouts, even 

without having to make a print selection. With a 

Figure 4b: ABPM – Pulse wave of the currently 

measurement 

selected 

mouse click on the button "Print", further pulse waves can be marked for the printout or once selected 

markings can be de-selected again. 


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Conclusion 

A high brachial blood pressure is an important cardiovascular risk factor. However, it is also common that 

patients having a comparable brachial blood pressure may differ considerably in their central systolic blood 

pressure values. 

There is evidence that anti-hypertensive treatment can affect the central blood pressure in another way than the 

brachial blood pressure. The actual and desired treatment effect of a comprehensive blood pressure reduction 

cannot be exclusively assessed on the basis of brachial blood pressure. [16]. 

Knowledge about the central blood pressure provides the following benefits: 

enables improved predictability of future cardiovascular events, going beyond the brachial blood 

pressure and other cardiovascular risk factors [6]. 

represents superior diagnostic precision compared to brachial blood pressure and 

enables an improved patient management instead of the usual care focusing on brachial blood 

pressure. 

In sum, the above statements demonstrate that the central blood pressure represents a better cardiovascular 

risk biomarker than the brachial blood pressure [5]. The central blood pressure can be exactly assessed with a 

suitable analysing algorithm and by using the brachial cuff, in an approach that is familiar to clinicians, 

acceptable for patients and accessible due to its wide-spread use. In other words: this modern blood pressure 

technology can meet the original purpose of the measurement of central aortic blood pressure, as it was 

intended more than 100 years ago. 

Although the turning point for routine application has not been reached yet, the available studies indicate that 

the central blood pressure should be used in clinical practice [10]. 

On the basis of the analysing software "custo screen" by custo med, it is possible to complement the classical 

blood pressure measurement by this important parameter. Based on the current ESH recommendations, the 

module complements custo diagnostic in the field of blood pressure analysis and provides highest 

measurement accuracy, a validated procedure and all that in one device without needing additional 

examinations. 

The exclusively brachial blood pressure measurement is not sufficient anymore today to characterize exactly 

enough all forms of hypertension in every age group and to create an adequate risk stratification. 


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Literature 

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Medicine: 70:793-799) 

[2] Mengden, T. (2008): Zentraler Blutdruck gewinnt an Bedeutung. DRUCKPUNKT, 2008 (2), S.24-25). 

[3] Middeke, M. (2014). Blutdruckmessung mittels Pulswellenanalyse: RR reicht nicht mehr. Deutsches 

Ärzteblatt, 111 (13), S. 551. 

[4] Kelly, R.P., Gibbs, H.H., O’Rourke, M.F., Daley, J.E., Mang, K., Morgan, J.J., Avolid, M.A. (1990): 

Nitroglycerin has more favourable effects on left ventricular afterload than apparent from 

measurement of pressure in a peripheral artery. European Heart Journal 11 (2):138-144 

[5] Vasan R.S. (2006): Biomarkers of cardiovascular disease: molecular basis and practical considerations. 

Circulation, 113:2335-236 

[6] Vlachopoulos, C., Xaplanteris, P., Aboyans, V., Brodmann, M., Cífkova, R., Cosentino, F., De Carlo, M., 

Gallino, A., Landmesser, U., Laurent, S., Lekakis, J., Mikhailidis, D.P., Naka, K.K., Protogerou, A.D., 

Rizzoni, D., Schmidt-Trucksäss, A., van Bortel, L., Weber, T., Yamashina, A., Zimlichman, R. (2015): The 

role of vascular biomarkers for primary and secondary prevention. A position paper from the 

European Society of Cardiology Working Group on peripheral circulation Endorsed by the Association 

for Research into Arterial Structure and Physiology (ARTERY) Society. Atherosclerosis 241: 507-532 

[7] Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D.L., Coca, A., de 

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Kjeldsen, S.E., Kreutz, R., Laurent, S., Lip, G.Y.H., McManus, R., Narkiewicz, K., Ruschitzka, F., 

Schmieder, R.E., Shlyakhto, E., Tsioufis, C., Aboyans, V., Desormais, I., ESC Scientific Document Group 

(2018): 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the 

management of arterial hypertension of the European Society of Cardiology (ESC) and the European 

Society of Hypertension (ESH). European Heart Journal. 39 (33): 3021–3104, 

[8] Rouxinol-Diasa, A., Araújo, S., Silva, J.A., Barbosa, L., Polónia, J. (2018): Association between 

ambulatory blood pressure values and central aortic pressure in a large population of normotensive 

and hypertensive patients. Blood Pressure Monitoring. 23(1): 24-32 

[9] Middeke, M. (2017). Zentraler aortaler Blutdruck. Bedeutender Parameter für Diagnostik und Therapie. 

Dtsch Med Wochenschr, (142). S. 1430-1436. 

[10] Sharman, J.E. (2015): Central pressure should be used in clinical practice. Artery Research, 9: 1-7 

[11] Mengden, T., Hausberg, M., Heiss, C., Mitchell, A., Nixdorff, U., Ott, C., Schmidt-Trucksäss, A., 

Wassertheurer, S. (2016): Arterielle Gefäßsteifigkeit – Ursachen und Konsequenzen. Empfehlungen der 

DeutschenHochdruckliga e. V. DHL®– Deutsche Gesellschaft für Hypertonie und Prävention. Der 

Kardiologe. 1: 38-46 

[12] Dörr, M., Richter, S., Eckert, S., Ohlow, M.-A., Hammer, F., Hummel, A., Dornberger, V., Genzel, E., 

Baulmann, J. (2019): Invasive Validation of Antares, a New Algorithm to Calculate Central Blood 

Pressure from Oscillometric Upper Arm Pulse Waves. Journal of Clinical Medicine. 8 (7): 1-15 

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Positionspapier zu Grundlagen, Dtsch med Wochenschr. 135: 4-14 

[14] Cheng, H.-M., Chuang, S.-Y., Sung, S.-H., Wu, C.-C., Wang, J.-J., Hsu, P.-F., Chao, C.-L., Hwang, J.-J., 

Wang T.-D., Huan, Chen, C.-H. (2019): 2019 Consensus of the Taiwan Hypertension Society and Taiwan 

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Hypertension. Acta Cardiol Sin, 35: 234-243 

[15] Vlachopoulos et al (2010) - Prediction of cardiovascular events and all-cause mortality with arterial 

stiffness, J Am Coll Cardiol. 55(13):1318-27 


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[16] Mengden, T. (2008): Messung des zentralen Aortendrucks – Teil II: Klinische Bedeutung zentral erhöhte 

Blutdrücke. Management Hypertonie - Journal by Fax. 8. Jahrgang 2008; Nr. 3. Quelle: 

https://www.hochdruckliga.de/tl_files/content/dhl/journal-by-fax/nr3_2008.htm 

[17] J. Baulmann, J., Herzberg, C-P., Störk, T. (2013): Die Renaissance von Pulswellengeschwindigkeit, 

Augmentation und zentralem Aortendruck als Determinanten des kardiovaskulären Risikos. Med Welt 

64: 30–33 

[18] Pereira T., Paulino, E., Maximiano, S., Rosa, M., Pinto, A.L., Mendes, M.J., Brito, J., Soares, P., Risse, J., 

Gose, S. (2019): Measurement of arterial stiffness and vascular aging in community pharmacies-The 

ASINPHAR@2action project. Journal of Clinical Hypertension, 21 (6): 813-821 

[19] Puzserova, A. & Bernatove, I. (2016): Blood Pressure Regulation in Stress: Focus on Nitric Oxide- 

Dependent Mechanisms. Physiological Research 65 (3): 309-342 

List of abbreviations 

AAMI 

ABPM 

BP 

BHS 

EVA 

ESC 

ESH 

PWA 

PWV 

RR 

Association for the Advancement of Medical Instrumentation 

Ambulatory Blood Pressure Monitoring 

Blood Pressure 

British Hypertension Society 

Early Vascular Aging 

European Society of Cardiology 

European Society of Hypertension 

Pulse Wave Analysis 

Pulse Wave Velocity 

Riva Rocci 

Table of figures 

Figure 1: Blood pressure and pulse wave in dependence of age [3]…………..……………………………. ………… Page 3 

Figure 2: Correlation between central and brachial blood pressure [3]……………………………………. ………… Page 4 

Figure 3a: Spot measurement with view of pulse wave and specification of brachial and central blood pressure 

values, pulse wave velocity as well as vascular age ……..……………………………….…………………... Page 7 

Figure 3b: Spot measurements: View of all pulse waves ………………….………..……………………………….. …...Page 7 

Figure 4a: ABPM - brachial and central blood pressure values with pulse wave velocity, vascular age and all 

measured pulse waves…..…………………………………………….…………………………….……….…Page 8 

Figure 4b: ABPM – Pulse wave of the currently selected measurement …………………….…………………….……. . Page 8 

Yours sincerely, 

custo med Team 

Important notice: 

The contents made available here have been generated to the best of our knowledge and belief. We do not assume any responsibility for damages resulting 

from the use of the information contained herein. All liability claims are invalid. The readers are advised to check the accuracy of all product-related information. 


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Central blood pressure and pulse wave velocity

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