Effects of peripheral vasoconstriction on the measurement of blood pressure in a finger

Wesseling, Karel H.; Settels, J.J.; Hoeven, G. M. A. van der; Nijboer, J. A.; Butijn, M. W. T.; Dorlas, J. C.

doi:10.1093/cvr/19.3.139

Cited by 153 publications

(55 citation statements)

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“…While subjects were normothermic, there was no evidence of pulse-wave amplification (Table 2). However, pulse-wave amplification is affected by a variety of factors, such as increased heart rate and vasodilation (4,34). It is, therefore, possible that some of the observed differences in SBP while heat stressed were due to increases in heart rate and vasodilation affecting pulse-wave amplification.…”

Section: Discussionmentioning

confidence: 99%

Validity of auscultatory and Penaz blood pressure measurements during profound heat stress alone and with an orthostatic challenge

Ganio

Lucas

Hastings³

et al. 2011

American Journal of Physiology-Regulatory, Integrative and Comp

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Ganio MS, Brothers RM, Lucas RAI, Hastings JL, Crandall CG. Validity of auscultatory and Penaz blood pressure measurements during profound heat stress alone and with an orthostatic challenge. Am J Physiol Regul Integr Comp Physiol 301: R1510 -R1516, 2011. First published August 10, 2011 doi:10.1152/ajpregu.00247.2011.-Despite frequent reporting of blood pressure (BP) during profound passive heat stress, both with and without a hypotensive challenge, the method by which BP is measured often varies between laboratories. It is unknown whether auscultatory and finger BP measures accurately reflect intra-arterial BP during dynamic changes in cardiac output and peripheral resistance associated with the aforementioned conditions. The purpose of this investigation was to test the hypothesis that auscultatory BP measured at the brachial artery, and finger BP measured by the Penaz method, are valid measures of intra-arterial BP during a passive heat stress and a heat-stressed orthostatic challenge, via lower body negative pressure (LBNP). Absolute (specific aim 1) and the change in (specific aim 2) systolic (SBP), diastolic (DBP), and mean BPs (MBP) were compared at normothermia, after a core temperature increase of 1.47 Ϯ 0.09°C, and during subsequent LBNP. Heat stress did not change auscultatory SBP (6 Ϯ 11 mmHg; P ϭ 0.16), but Penaz SBP (Ϫ22 Ϯ 16 mmHg; P Ͻ 0.001) and intra-arterial SBP (Ϫ11 Ϯ 13 mmHg P ϭ 0.017) decreased. In contrast, DBP and MBP did not differ between methods throughout heat stress. Compared with BP before LBNP, the magnitude of the reduction in BP with all three methods was similar throughout LBNP (P Ͼ 0.05). In conclusion, auscultatory SBP and Penaz SBP failed to track the decrease in intra-arterial SBP that occurred during the profound heat stress, while decreases in arterial BP during an orthostatic challenge are comparable between methodologies. lower body negative pressure; passive heat stress; arterial blood pressure VARIOUS METHODS ARE USED TO measure arterial blood pressure (BP) in the passively heat-stressed human (6,8,18,20,31,35,36). The most valid approach is an intra-arterial catheter connected to a calibrated transducer (BP INTRA ). Although BP INTRA is the gold standard, physician assistance and supervision are often required, and there is significant cost and subject risk, resulting in BP INTRA measurements being prohibitive in most settings.An alternative to BP INTRA is automated auscultatory BP (BP AUSC ). This method is often used because of the relatively low cost, ease of use, and its capacity to be used in a variety of settings (26). However, this method is limited because each measurement requires ϳ30 s, thus prohibiting the use of BP AUSC during conditions when arterial BP is rapidly changing (e.g., when a subject is approaching presyncope during an orthostatic tolerance test).In the 1970's, noninvasive beat-by-beat BP measurements were made possible using a finger cuff coupled with Penaz technology (25). Penaz-derived BP (BP PENAZ ) recordings have been validated for resting...

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Section: Discussionmentioning

confidence: 99%

Validity of auscultatory and Penaz blood pressure measurements during profound heat stress alone and with an orthostatic challenge

Ganio

Lucas

Hastings³

et al. 2011

American Journal of Physiology-Regulatory, Integrative and Comp

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“…This method uses a finger cuff, which was worn on the third finger of the nondominant hand. The method of operation of the Finapres monitor has been described in detail by several authors (42)(43)(44)(45). It has been shown to track intraarterial readings extremely well, even during sudden changes in blood pressure (46), making it quite useful for reactivity and recovery testing.…”

Section: Recording Of Cardiovascular Activitymentioning

confidence: 99%

The Role of Angry Rumination and Distraction in Blood Pressure Recovery From Emotional Arousal

Gerin

Davidson

Christenfeld

et al. 2006

Psychosomatic Medicine

219

203

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Objective: Cardiovascular recovery of prestress baseline blood pressure has been implicated as a possible additional determinant of sustained blood pressure elevation. We hypothesize that angry ruminations may slow the recovery process. Method: A within-subjects design was used in which resting baseline blood pressure and heart rate measurements were assessed on 60 subjects, who then took part in two anger-recall tasks. After each task, subjects sat quietly and alone during a 12-minute recovery period randomized to with or without distractions. During baseline, task, and recovery, blood pressure was continuously monitored; during recovery, subjects reported their thoughts at five fixed intervals. Results: Fewer angry thoughts were reported in the distraction condition (17%) compared with no distraction (31%; p ϭ .002); an interaction showed that this effect was largely the result of the two intervals immediately after the anger-recall task. Trait rumination interacted with distraction condition such that high ruminators in the no-distraction condition evidenced the poorest blood pressure recovery, assessed as area under the curve (p ϭ .044 [systolic blood pressure] and p ϭ .046 [diastolic pressure]). Conclusions: People who have a tendency to ruminate about past anger-provoking events may be at greater risk for target organ damage as a result of sustained blood pressure elevations; the effect is exacerbated when distractions are not available to interrupt the ruminative process.

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“…12 Therefore any periheral BP method such as the Finapres requires rigorous validation to understand its strengths and limitations. The accuracy of the Finapres compared with intra-arterial reference pressure has now been assessed in many studies [3][4][5][6][7][8][9][10][13][14][15][16][17][18][19][20][21][22][23] without any clear consensus emerging on the average performance of the method; precision data has been infrequently reported. 20,24 This paper is a synthesis of these literature data; a novel statistical method of re-sampling allowed a global overview of the performance of the system to be derived.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and precision of blood pressure determination with the Finapres: an overview using re-sampling statistics

1998

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Effects of peripheral vasoconstriction on the measurement of blood pressure in a finger

Cited by 153 publications

References 0 publications

Validity of auscultatory and Penaz blood pressure measurements during profound heat stress alone and with an orthostatic challenge

Validity of auscultatory and Penaz blood pressure measurements during profound heat stress alone and with an orthostatic challenge

The Role of Angry Rumination and Distraction in Blood Pressure Recovery From Emotional Arousal

Accuracy and precision of blood pressure determination with the Finapres: an overview using re-sampling statistics

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