Central Blood Pressure and Prediction of Cardiovascular Events

Junichiro      Hashimoto; Sadayoshi      Ito

Abstract

Cardiovascular disease is the leading cause of death worldwide. Hypertension is a major contributor to cardiovascular risk, and the blood pressure serves as an important biomarker of the diagnosis, prognosis and treatment. Compared with the blood pressure conventionally measured in the brachial artery, the blood pressure in the central aorta is more strongly influenced by aortic stiffness and peripheral wave reflection, both of which relate to cardiovascular risk independently of the brachial blood pressure. The central blood pressure corresponds to the pressure exerted at the level of the heart, brain and kidney, and its elevation inevitably causes the simultaneous progression of vascular damage in these target organs, eventually leading to adverse outcomes due to cardiovascular, cerebrovascular and renal diseases. This review will focus on the current evidence as to the predictive value of central blood pressure measures in relation to cardiovascular events and also on the possible pathophysiological mechanisms connecting central hemodynamics and cardiovascular disease.

Keywords: Central blood pressure, pulse wave, coronary heart disease, chronic kidney disease, cardiovascular outcome, prospective study, wave reflection, augmentation index, aortic stiffness, arteriosclerosis