Clinical Implications of Non-Invasive Measurement of Central Aortic Blood Pressure

Mariusz      Stepien; Maciej      Banach; Piotr      Jankowski; Jacek      Rysz

Abstract

Central arterial systolic blood pressure is a very important factor in the pathophysiology of cardiovascular diseases. Central arterial pressure is a better predictor of cardiovascular risk than peripheral brachial blood pressure. Measurement of central blood pressure is useful for a diagnosis of spurious systolic hypertension in young people. Antihypertensive drugs have a different impact on central blood pressure, for example angiotensin converting enzyme inhibitors, antagonists of angiotensin II receptors, calcium channel blockers more effectively lower central blood pressure than betablockers, despite all of those drugs (including beta-blockers) having a similar impact on peripheral pressure. This mechanism may be responsible for the beneficial effect of some antihypertensive drugs on cardiovascular end points observed in clinical trials, despite a low peripheral hypotensive effect. However, further clinical trials are required to provide more evidence for the prognostic and therapeutic implications of the measurement of central blood pressure before adopting its routine application in clinical practice.

Keywords: Blood pressure, central blood pressure, clinical implications, cardiovascular dis-eases, angiotensin II receptors, calcium channel blockers, beta-blockers, Mean blood pressure, diastolic blood pressure, Peripheral systolic blood pressure, pulse pressure, cold pressor test, hypertension, antihypertensive treatment, Pulse wave analysis, hypercholesterolemia, Framingham Heart Study, ICAR Dicomano Study, carotid atherosclerosis, Marfan syndrome, obstructive sleep apnea syndrome, HYPOTENSIVE THERAPY, nicorandil, augmenta-tion index, Angiotensin, –, converting enzyme inhibitors (ACEI), angiotensin II receptor blocking agents, Antihypertensive drugs, ramipril, losartan, eprosartan