On the reliability of the Penaz cuff during systemic and local fingertip vasodilatation at rest and in exercise

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Abstract
Summary To compare the readings of blood pressure by the Riva-Rocci (RR) method with those of peripheral arterial pressure (PAP) as recorded by the Finapres (FP) device, exercise was performed by six male subjects on a cycle ergometer at a constant exercise intensity of 140 W. In addition, forearm volume was determined by impedance plethysmography. At rest, systolic FP values exceeded RR values by ≥ 10 mmHg. During 60-min exercise both values at first increased almost in parallel with each other. While RR reached a plateau after 3 min, FP then started to decrease continuously up to the 10th min and finally stabilized at 20–30 mmHg below RR. The impedance values showed a similar declining slope, indicating vasodilatation. To separate the effects of sympathetic drive from heat elicited vasodilatation, a second experimental series was performed with ischaemic static calf exercise (5 min, 90 N), since this increases the sympathetic tone but prevents systemic heat distribution. In contrast to findings reported from intra-arterial measurements, no exercise effect on the pulse pressure amplification was obtained. However, the heating of one fingertip distal to the FP-cuff led to a significant decrease in PAP compared to the control recording made simultaneously from the other hand. It was concluded that heat induced vasodilatation may make FP unrepresentative of systemic blood pressure, in particular during exercise. Moreover, the FP-cuff seemed to induce substantial vasoconstriction due to venous occlusion. The FP method would therefore be useful for monitoring continuously systemic blood pressure if no (dilative) vasomotor changes occurred or their ranges and time courses were known sufficiently well.