How Drugs Influencing Central Blood Pressure Prevent Atherosclerosis Complications?
Piotr Jankowski, Michel E. Safar and Kalina Kawecka-Jaszcz
Although the differences between central and peripheral blood pressure (BP) have been known for decades, the
consequences of decision-making based on peripheral rather than central BP have only recently been recognized. Central
PP is closer to the heart, coronary and carotid arteries, which are the most important sites of cardiovascular events. The influence
of cyclic stretch (owing to cyclic changes in BP) on the arterial wall has been documented at every stage of atherosclerosis
development. Apart from mediating atherosclerosis progression and plaque instability, the pulsatile component
of BP is the main mechanism leading to plaque rupture and, consequently, to acute coronary syndromes and other vascular
complications. Latest evidence suggests that the effect of some antihypertensive drugs on central BP (especially on central
pulse pressure) is greater when compared with the effect on peripheral pressure, especially if systolic or pulse pressure are
measured. Recently, a new group of drugs (advanced glycation end products cross-link breakers) were developed which
have ability to decrease pulsatile component of blood pressure. The principal goal of the present review is to update the
latest advances in this field.
Antihypertensive drugs, atherosclerosis, central blood pressure, pressure amplification, pressure augmentation
Department of Cardiology and Hypertension, Jagiellonian University Medical College, 17 Kopernik St. 31-501 Krakow, Poland;