The standard equation used to calculate mean arterial pressure (MAP) assumes that
diastole persists for 2/3 and systole for 1/3 of each cardiac cycle. This ratio is
altered when heart rate increases, and therefore we investigated the efficacy of predicting
MAP during exercise using non-invasive indirect methods. Eight subjects exercised
on a cycle ergometer for 3 minute intervals to elicit heart rates between 100 - 110,
120 - 130, 140 - 150, 160 - 170, and 180 - 190 beats/min. In the last minute of each
3 min interval an ECG recording was taken and systolic (SP) and diastolic (DP) blood
pressure was measured by manual auscultation. MAP was calculated for each heart rate
interval by: MAP = DP + 1/3(SP - DP) (method A), and MAP =DP + FS (SP - DP) (method B), where Fs is the fraction of the cardiac cycle comprising systole,
measured from the ECG. FS increased from 0.35 ± 0.049 at rest to 0.47 ± 0.039 at a heart rate of 180 - 190
beats/min. MAP measured by method B was consistently greater than MAP calculated by
method A at all heart rates greater than resting heart rate (p < 0.01). The error
incurred when using the standard MAP equation (method A) to derive MAP during exercise
(measured as the percentage difference between method A and B) increased linearly
with heart rate (r = 0.98). The standard MAP equation should not be applied during
exercise, as it does not account for the change in the systolic : diastolic period
ratio as heart rate increases.
Key words:
Blood pressure - heart rate - arterial systolic period - arterial diastolic period
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T. Oosthyse
Department of Physiology University of the Witwatersrand, Medical School
P. O. Wits
Johannesburg 2050
South Aftrica
Phone: + 27 (11) 6472363
Fax: + 27 (11) 6432765
Email: 127tanja@chiron.wits.ac.za