Abstract
Although the clinical relevance of brachial blood pressure (BP) measurement for cardiovascular (CV) risk stratification is nowadays widely accepted, this approach can nevertheless present several limitations. Pulse pressure (PP) amplification accounts for the notable increase in PP from central to peripheral arterial sites. Target organs are more greatly exposed to central hemodynamic changes than peripheral organs. The pathophysiological significance of local BP pulsatility, which has a role in the pathogenesis of target organ damage in both the macro- and the microcirculation, may therefore not be accurately captured by brachial BP as traditionally evaluated with cuff measurements. The predictive value of central systolic BP and PP over brachial BP for major clinical outcomes has been demonstrated in the general population, in elderly adults and in patients at high CV risk, irrespective of the invasive or non-invasive methods used to assess central BP. Aortic stiffness, timing and intensity of wave reflections, and cardiac performance appear as major factors influencing central PP. Great emphasis has been placed on the role of aortic stiffness, disturbed arterial wave reflections and their intercorrelation in the pathophysiological mechanisms of CV diseases as well as on their capacity to predict target organ damage and clinical events. Comorbidities and age-related changes, together with gender-related specificities of arterial and cardiac parameters, are known to affect the predictive ability of central hemodynamics on individual CV risk.
Keywords: Cardiovascular risk prediction, central pulse pressure, aortic stiffness, wave reflections, atherosclerosis, microcirculatory damage.
Current Pharmaceutical Design
Title:Central Hemodynamics in Risk Assessment Strategies: Additive Value Over and Above Brachial Blood Pressure
Volume: 21 Issue: 6
Author(s): Alexandra Yannoutsos, Elisa R. Rinaldi, Yi Zhang, Athanassios D. Protogerou, Michel E. Safar and Jacques Blacher
Affiliation:
Keywords: Cardiovascular risk prediction, central pulse pressure, aortic stiffness, wave reflections, atherosclerosis, microcirculatory damage.
Abstract: Although the clinical relevance of brachial blood pressure (BP) measurement for cardiovascular (CV) risk stratification is nowadays widely accepted, this approach can nevertheless present several limitations. Pulse pressure (PP) amplification accounts for the notable increase in PP from central to peripheral arterial sites. Target organs are more greatly exposed to central hemodynamic changes than peripheral organs. The pathophysiological significance of local BP pulsatility, which has a role in the pathogenesis of target organ damage in both the macro- and the microcirculation, may therefore not be accurately captured by brachial BP as traditionally evaluated with cuff measurements. The predictive value of central systolic BP and PP over brachial BP for major clinical outcomes has been demonstrated in the general population, in elderly adults and in patients at high CV risk, irrespective of the invasive or non-invasive methods used to assess central BP. Aortic stiffness, timing and intensity of wave reflections, and cardiac performance appear as major factors influencing central PP. Great emphasis has been placed on the role of aortic stiffness, disturbed arterial wave reflections and their intercorrelation in the pathophysiological mechanisms of CV diseases as well as on their capacity to predict target organ damage and clinical events. Comorbidities and age-related changes, together with gender-related specificities of arterial and cardiac parameters, are known to affect the predictive ability of central hemodynamics on individual CV risk.
Export Options
About this article
Cite this article as:
Yannoutsos Alexandra, Rinaldi R. Elisa, Zhang Yi, Protogerou D. Athanassios, Safar E. Michel and Blacher Jacques, Central Hemodynamics in Risk Assessment Strategies: Additive Value Over and Above Brachial Blood Pressure, Current Pharmaceutical Design 2015; 21 (6) . https://dx.doi.org/10.2174/1381612820666141023164125
DOI https://dx.doi.org/10.2174/1381612820666141023164125 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Hyperandrogenism, Insulin Resistance and Hyperinsulinemia as Cardiovascular Risk Factors in Diabetes Mellitus
Current Diabetes Reviews New Horizons in Diabetes Therapy
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) CETP Inhibitory Activity of Chlorobenzyl Benzamides: QPLD Docking, Pharmacophore Mapping and Synthesis
Letters in Drug Design & Discovery PDE-5 Inhibitors: Clinical Points
Current Drug Targets Pharmacological Approaches of Alzheimer's Disease: An Update
Current Drug Therapy Are Carbonic Anhydrase Inhibitors Suitable for Obtaining Antiobesity Drugs ?
Current Pharmaceutical Design Fluoxetine and all other SSRIs are 5-HT<sub>2B</sub> Agonists - Importance for their Therapeutic Effects
Current Neuropharmacology Serum Albumin Concentration and Cognitive Impairment
Current Alzheimer Research Hydroximic Acid Derivatives: Pleiotropic Hsp Co-Inducers Restoring Homeostasis and Robustness
Current Pharmaceutical Design The Role of Obesity in the Development of Polycystic Ovary Syndrome
Current Pharmaceutical Design Lipid Management and Peripheral Arterial Disease
Current Drug Targets Effects of Ox Bile Extract on the Phospholipids and Fatty Acids Membrane Composition of Salmonella enterica Serovar Typhimurium seqA Mutant Strain
Current Chemical Biology Phytoestrogen-Rich Dietary Supplements in Anti-Atherosclerotic Therapy in Postmenopausal Women
Current Pharmaceutical Design APE1/Ref-1Role in Redox Signaling: Translational Applications of Targeting the Redox Function of the DNA Repair/Redox Protein APE1/Ref-1
Current Molecular Pharmacology COVID-19: Our Current Knowledge of Epidemiology, Pathology, Therapeutic Approaches, and Diagnostic Methods
Anti-Cancer Agents in Medicinal Chemistry The Impact of Metabolic Disease Associated with Metabolic Syndrome on Human Pregnancy
Current Pharmaceutical Biotechnology Determination of Phytochemicals by GC-MS in Two Fractions (17 and 21) of Methanol Extract of Loranthus Micranthus and their Antioxidant and Anti-Inflammatory Activity
The Natural Products Journal A Yeast Extract High in Bioactive Peptides has a Blood-Pressure Lowering Effect in Hypertensive Model
Current Medicinal Chemistry Parathyroid Hypertension: A Rare, but Curable form of Secondary Hypertension
Current Hypertension Reviews Exercise Prescription for Post-Menopausal Women with Obesity
Current Women`s Health Reviews