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CLINICAL STUDIES

Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension

James D. Cameron, MD, MEngSc^* , Barry P. McGrath, MD and Anthony M. Dart, DPhil, MB, BCh

^* La Trobe University, Melbourne, Victoria, Australia
Baker Medical Research Institute, Melbourne, Victoria, Australia
Monash University Department of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia

Manuscript received October 30, 1997; revised manuscript received June 24, 1998, accepted July 9, 1998.

Address for correspondence: Dr. J. D. Cameron, Head, Biochemical Group, Department of Electronic Engineering, La Trobe University, Bundoora, Victoria, Australia 3083
j.cameron{at}ee.latrobe.edu.au

Objectives. The purposes of this study were to investigate the use of radial artery applanation tonometry and a generalized transfer function for the assessment of central aortic pressure augmentation in subjects taking commonly used antihypertensive agents (angiotensin-converting enzyme inhibitors, beta-adrenergic blockers, Ca²⁺ antagonists, diuretic therapy).

Background. Applanation tonometry of the radial artery with a generalized transfer function has been proposed as a means of assessing central aortic blood pressure. Recently, a commercial apparatus based on this technique has become available; we therefore examined the effect of a generalized transfer function on derived central aortic pressure compared with measured brachial blood pressures and also investigated the potential of this technique to assess the influence of differing drug therapy.

Methods. Two hundred and sixty-two hypertensive patients on stable medication were studied using the PWV Medical Blood Pressure Analysis System (version 2, DAT-1).

Results. In univariate analysis, augmentation index showed association with age, sex, height and heart rate. In multivariate analysis, diastolic blood pressure and age (positively), height and heart rate (negatively) and sex were significantly associated. After adjustment for these variables, pressure augmentation was not associated with any antihypertensive treatment investigated. Linear relationships were demonstrated between brachial blood pressures and corresponding central pressures derived by transfer function methods.

Conclusions. Our findings suggest that if adjustment for central-peripheral pressure difference is necessary, simple linear relationships may be sufficient. Age, heart rate and height but not the class of antihypertensive medication affected the degree of pressure augmentation observed using this technique.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   AI = augmentation index   AP = augmentation pressure   DBP = diastolic blood pressure   PWV = pulse wave velocity   SBP = systolic blood pressure   TF = transfer function

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