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(Hypertension. 2007;49:1207.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

Impedance Progress

Aortic Diameter Rears Its Head Again?

Gary F. Mitchell

From the Cardiovascular Engineering, Inc, Waltham, Mass.

Correspondence to Gary F. Mitchell, MD, Cardiovascular Engineering, Inc, University Office Park, Building 2, 51 Sawyer Rd, Suite 100, Waltham, MA 02453. E-mail GaryFMitchell@mindspring.com

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Changes in global arterial function and blood pressure pulsatility play an important role in the exponential increase in the incidence of various common afflictions of aging. However, our current approach to hemodynamics, evaluating the peak (systolic blood pressure) and trough (diastolic blood pressure) of the blood pressure waveform in the arm, provides a limited view of pulsatile hemodynamics. As a first refinement, blood pressure can be separated into steady-flow and pulsatile components, mean arterial pressure (MAP) and pulse pressure (PP), respectively. Numerous recent studies have shown that many serious clinical events may be more closely linked to PP, which is related to large artery stiffness, rather than MAP, which is determined by small artery function and cardiac output. However, systolic blood pressure or PP in the arm probably does not tell the full story. Conventional brachial systolic blood pressure represents a variable composite of PP (large arteries) and MAP (small arteries), depends on ventricular ejection characteristics and arterial properties, and, because of transmission delays and wave reflection, may not be fully representative of central aortic pressure, which may be more relevant to cardiac and cerebral function. These additional sources of variability may have important implications for the pathogenesis of cardiovascular disease and response to treatment.

The study by Segers et al¹ in the current issue of Hypertension represents an important step forward in our quest to quantify the effects of regional arterial function on the pathogenesis of cardiovascular disease in the community. The authors are reporting pulsatile hemodynamics from the . . . [Full Text of this Article]

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Noninvasive (Input) Impedance, Pulse Wave Velocity, and Wave Reflection in Healthy Middle-Aged Men and Women

Patrick Segers, Ernst R. Rietzschel, Marc L. De Buyzere, Sebastian J. Vermeersch, Dirk De Bacquer, Luc M. Van Bortel, Guy De Backer, Thierry C. Gillebert, Pascal R. Verdonck on behalf of the Asklepios investigators
Hypertension 2007 49: 1248-1255. [Abstract] [Full Text] [PDF]

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