ABSTRACT
It is a supreme paradox that modern physicians, almost without exception, while surrounded by twenty-first century aids to diagnosis and therapy, use the arterial pulse only to assess heart rate and rhythm, and take no notice of the other information that the pulse is capable of imparting. Physicians do, of course, through use of the cuff sphygmomanometer, gauge the peak and nadir of the pulse and record their value as systolic and diastolic blood pressure. We have already discussed how inaccurate these values can be, with standard deviations up to 10mmHg common in comparison of simultaneously determined indirect to directly recorded values in the brachial arteries. We have also discussed how diastolic brachial blood pressure was over-interpreted as the sole guide to elevated pressure for almost a century, and how, even now, brachial
systolic pressure is misinterpreted as a measure of peak left ventricular pressure (Mullens et al., 2008; Yancy, 2008).
