Is Noninvasive Brachial Systolic Blood Pressure an Accurate Estimate of Central Aortic Systolic Blood Pressure?

Yuan Ta Shih, Hao Min Cheng, Shih Hsien Sung, Shao Yuan Chuang, Wei Chih Hu, Chen Huan Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


OBJECTIVES Noninvasive brachial systolic blood pressure (nSBP-B) usually approaches invasive central systolic blood pressure (iSBP-C) with a high correlation. Whether nSBP-B is an accurate estimate of iSBP-C remained to be investigated. Thus, this study aimed to compare the errors of nSBP-B and noninvasive central systolic blood pressure (nSBP-C) with different techniques in estimating iSBP-C. METHODS Simultaneous invasive high-fidelity central aortic pressure waveforms and the noninvasive left brachial pulse volume recording (PVR) waveform were recorded in a Generation group (N = 40) and a Validation group (N = 100). The accuracy of the noninvasive estimates of iSBP-C obtained from analysis of the calibrated PVR waveform using the generalized transfer function (GTF), pulse waveform analysis (PWA), and N-point moving average (NPMA) methods was examined in the Validation group by calculating the mean absolute error (MAE). RESULTS In Generation group, the MAE was 4.6±4.1mm Hg between nSBP-B and invasive brachial SBP, and 6.8±5.5mm Hg between nSBP-B and iSBP-C. In comparison, the MAE of between iSBP-C and nSBP-C with PWA, NPMA, and GTF were 5.5±4.5, 5.8±4.9, and 5.9±5.0mm Hg, respectively. In Validation group, the MAE of nSBP-B (6.9±4.6mm Hg) for estimating iSBP-C was significantly greater than that of PWA (5.0±3.4mm Hg) and NPMA (6.1±4.4mm Hg), and GTF (6.1±4.9mm Hg). The percentage of absolute band error ≤5mm Hg was 62% for nSBP-B, 69% for GTF, 83% for PWA, and 69% for NPMA. CONCLUSIONS The accuracy of nSBP-B was inferior to the n SBP-C measures in estimating iSBP-C.

Original languageEnglish
Pages (from-to)1283-1291
Number of pages9
JournalAmerican Journal of Hypertension
Issue number11
StatePublished - 1 Nov 2016


  • calibration error
  • central blood pressure
  • hypertension


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