The Effects of Brachial Arterial Stiffening on The Accuracy of Oscillometric Blood Pressure Measurement: A Computational Model Study

Abstract

Oscillometric noninvasive blood pressure measurement (ONBPM) is nowadays widely applied in health care. However, ONBPM has been found to exhibit large interindividual variability in accuracy. In the present study, we developed a theoretical model to describe the mechanics of the brachial arterial wall and particularly arterial stiffening dominated respectively by wall thickening and elastin degeneration. The model was incorporated into a cardiovascular-cuff model to investigate the effects of brachial arterial stiffening on the accuracy of ONBPM. It was found that wall-thickening-dominated arterial stiffening induced overestimate of the systolic pressure, whereas the elastin-degeneration-dominated arterial stiffening induced overestimate of both the systolic pressure and the diastolic pressure. The findings support the clinical observation that pseudo-hypertension is more prevalent in the elderly, and at the same time imply that arterial stiffness indices (e.g., compliance of artery, pulse wave velocity) assessed under the physiological pressure (generally between 70 and 150mmHg) conditions may be insufficient for assessing the accuracy of ONBPM.

Keywords

• oscillometric blood pressure measurement
• model
• cuff
• brachial artery
• arterial stiffening
• wall thickening
• elastin degeneration