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CASP

For more than a century, the hypertension management was based on non-invasive measurement of brachial blood pressure (BP), but not central aortic pressure (CAP) measurement. The reason for not measuring the CAP widely is mainly due to the fact that, to-date, there is no device accurate, affordable, non-invasively and simple enough to be used in a home or clinic setting. The present technique is either an invasive angiographic measurement, or using a very expensive and cumbersome system which is only used in research labs. 

 

                                     
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 Figure: CASP- the pressure at the root of the Aorta (largest artery of the body) as it emerges from the heart 

Central Aortic Systolic Pressure (CASP), it has been shown in many studies to be the strongest independent risk factors for stroke, heart attacks and the likelihood of survival after such an event.  

CASP – Central Aortic Systolic Pressure.

This is the blood pressure at the root of the aorta or the largest artery in the body, as the blood is being pumped out of the heart. This pressure is called Central Aortic Systolic Pressure or CASP. CASP has been shown to be an important factor in the relation to strokes and cardiovascular events, more so than the brachial pressure, or the pressure at the arm commonly.  

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CASP is different and usually lower than the brachial pressure in normal people. When we are young, below 40 years old, the difference between CASP and the brachial pressure can be significant (up to 30 mmHg). However, as we age, the aorta gets stiffer and the compliance reduces. As a result, the CASP increases and comes much closer to the brachial pressure. In patients with high blood pressure, the CASP can be abnormally high for his age, showing “pre-mature” stiffening of the aorta. 

It has also been shown that certain class of drugs used in the treatment of high blood pressure can also have an adverse effect on the CASP, increasing it instead of reducing, as shown in the CAFÉ study. Therefore it is important to show that the treatment a patient is taking actually result in lowering the CASP and not the reverse. By reducing the CASP of the patient, we are reducing the risks of stroke and heart events.


A-PULSE CASP®

This is a patented software which is able to measure the CASP of a patient in 5 minutes. A-PULSE CASP® is FDA approved. It has been validated in more than 10,000 patient waveforms non-invasively with a correlation R= 0.996. 

A-PULSE CASP® is designed to measure the CASP in a simple clinic or Pharmacy setting. The BPro device is used, together with a computer or laptop, using a USB port. It gives real time recording of the arterial waveforms which can be replay at any later time for further study. Another strong feature of A-Pulse is the ability to compare the various waveforms on different dates of the same patient, or different patients. All the parameters including the CASP are displayed instantaneously, the waveforms superimposed for comparison. The A-PULSE CASP® is the only device that can measure the CASP in a clinic setting, easy to use and accurate. It is the evidence-based approach to the management of hypertension.

 

How to measure CASP

Invasive method 
This is direct measurement and has been considered as the most accurate method. To perform the measurement, a catheter must be inserted into the aortic root from brachial or femoral artery, which is obviously an invasive method and could result in complications.

Non-invasive method – BPro® + A-PULSE CASP®

HealthSTATS (HS) invented a device named BPro which is able to capture radial pressure waveforms. Furthermore, HS developed a proprietary formula, which was built in a commercial software A-PULSE CASP®, to derive CASP from the calibrated radial pressure waveform.

 

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Non-invasive method – A-PULSE CASPro® New Please refer to Product Section

 

Central Aortic Systolic Pressure Clinical papers

1. Bryan Williams, Peter S. Lacy. Differential impact of blood pressure – Lowering drugs on Central Aortic Pressure and clinical Outcomes: Principal Results of the Conduit Artery Function Evaluation (CAFÉ) Study. America Hearts Association, Feb 13, 2006

2. Athanase D. Protogerou, Theodore G. Papaooannou. Central blood pressures: do we need them in the management of cardiovascular disease? Is it a feasible therapeutic target? Journal of Hypertension, 2007

3. Mary J. Roman, Richard B. Devereux. Central Pressure More Strongly Relates to Vascular Disease and Outcome Than Does Brachial Pressure: The String Heart Study. Hypertension 2007. 

4. Bryan Williams, Peter S. Lacy. Central aortic pressure and clinical outcomes. Journal of Hypertension 2009.

 

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