Published online before print June 29, 2009, doi: 10.1161/HYPERTENSIONAHA.109.134379
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(Hypertension. 2009;54:375.)
© 2009 American Heart Association, Inc.
Seventh International Workshop on Structure and Function of the Vascular System |
Role of Pulse Pressure Amplification in Arterial Hypertension
Experts’ Opinion and Review of the Data
From the Australian School of Advanced Medicine (A.A.), Macquarie University, Sydney; Heymans Institute of Pharmacology (L.V.B.) and Biofluid, Tissue and Solid Mechanics for Medical Applications (bioMMeda) Institute, Biomedical Technology (P.S.), Ghent University, Belgium; Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, HEGP, Service de Pharmacologie (P.B.), and Hotel-Dieu Centre de Diagnostic et de Thérapeutique (M.E.S.), Paris, France; Wales Heart Research Institute (J.R.C.), Cardiff University, UK; Clinical Pharmacology Unit (C.M.E.), University of Cambridge, UK; Hypertension Center, 3rd Department of Medicine (A.P.), National and Kapodistrian University of Athens, Greece; Weill Cornell Medical College (M.J.R.), New York, USA; and State University of New York, Upstate Medical University (H.S.), Syracuse, USA.
Correspondence to A. Protogerou, MD, Hypertension Center, 3rd University Department of Medicine, 152, Mesogeion Ave, Athens 115 27, Greece. E-mail aprotog@med.uoa.gr
Key Words: pressure amplification • wave propagation • arterial stiffness • wave reflection
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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Arterial hypertension is a major modifiable cardiovascular (CV) risk factor worldwide based on observational studies of brachial artery blood pressure (BP). In the latest guidelines of the European Society of Hypertension1 for the management of arterial hypertension, aortic stiffness was introduced as an index of target organ damage. Three additional cardinal features of BP were also acknowledged: (1) systolic BP and pulse pressure (PP) may differ between the brachial artery and central arteries (ie, the aorta and its proximal branches), (2) the effects of antihypertensive drug treatment on brachial BP does not invariably reflect those seen on central BP, and (3) central BP is significantly related to CV events. Moreover, the guidelines acknowledged that noninvasive methods exist for the assessment of central hemodynamic parameters, such as central PP, and highlighted the need for large scale interventional studies that will further confirm the prognostic importance of central BP.
Two years ago, coincident with the 6th International Workshop on the "Structure and Function of the Vascular System," in Paris, a consensus document on the role of central BP in arterial hypertension was published.2 It concluded that there is "mounting evidence suggesting that central BP and indices correlate more closely with intermediate markers of CV risk than brachial BP". It was also suggested that clinicians and researchers need to become familiarized with the disparity between peripheral and central BPs, ie, the phenomenon of pressure wave amplification. The present document is designed to address this need.
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Pulse Wave Amplification: Basic Definitions |
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The left ventricle consumes energy by ejecting blood
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