Alternative Interpretations on the Case for Non-invasive Central Aortic Pressure Monitoring

The derivation and application of estimates of central blood pressure continues to generate discussion and debate with published commentaries expressing a range of views regarding the use of central blood pressure (BP) in the management of hypertension. Possibly the main hindrance to proposing any need for general usage of non-invasive central BP are the recent and substantive population studies and individual patient meta-analysis showing that major cardiovascular outcomes have similar strengths of association with central and brachial cuff BPs [5, 6]. [4] acknowledge, studies of central BP (relatively small, retrospective and usually in samples of convenience) have varied in relative prognostic result; however, in no study has traditional brachial BP not shown the expected prognostic benefit. There would need to be good evidence to introduce further “black-box” influences and since it is well established that non-invasive central BP results are device-dependent [11, 12], this additional level of variability without any evidence of benefit would be poor practice.