Association between functional capacity, pulse wave analysis and pulse palpation in patients with systemic arterial hypertension

Abstract

Introduction: High blood pressure (HBP) is characterized by systolic and/or diastolic blood pressure higher than 140/90 mmHg. It stands out as one of the major public health problems and contributes to target-organ damage, skeletal muscles, impacting functional capacity of these patients. Pulse wave analysis (PWA) can be used to quantify arterial remodeling, while grip strength reflects injury. Traditional Chinese Medicine (TCM) diagnosis patterns or subtypes of diseases from four procedures: inspection, auscultation-olfaction, interrogation and radial pulse palpation, by pulse image analysis (PIA). Objective: The study aims to evaluate the association between functional capacity, PWA and PIA in HBP patients. Methods: Observational, cross-sectional study enrolled 45 patients with HBP, also assessed for complementary exams (electrocardiogram, laboratorial data). Patients were submitted to PWA by applanation tonometry, PIA by “simultaneous pressing”, Chinese diagnosis was identified with pattern differentiation based on an automated method; international physical activity questionnaire (IPAQ), and manual dynamometry. Results: Significant multivariate main effects were observed for depth (λ=0,648, F_5,29=3,149, p=0,022, n²=0,352), strength (λ=0,608, F_5,29=3,736, p=0,010, n²=0,392), and speed (λ=0,535, F_5,29=5,302, p=0,002, n²=0,465). General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥62.5 mmHg and systolic blood pressure ≥149.5 mmHg, whereas a superficial pulse was found for heart rate ≥58.25 heartbeats/min; a fast pulse was found for heart rate ≥69.6 heartbeats/min and pulse wave velocity ≥9.185 m/s. Conclusion: PIA is associated to PWA and hemodynamics in patients with HBP so quantitative variables related to wave propagation pulse and hemodynamics have information to describe sensations of qualitative pulse as reported in TCM.