Central Hemodynamics for Risk Reduction Strategies: Additive Value Over and Above Brachial Blood Pressure

Title:Central Hemodynamics for Risk Reduction Strategies: Additive Value Over and Above Brachial Blood Pressure

Volume: 21 Issue: 6

Author(s): Elisa R. Rinaldi, Alexandra Yannoutsos, Claudio Borghi, Michel E. Safar and Jacques Blacher

Affiliation:

Keywords: Cardiovascular risk reduction, central pulse pressure, aortic stiffness, anti-hypertensive treatment.

Abstract: Reduction strategies of blood pressure, as a modifiable cardiovascular risk, are currently based on office assessment of brachial artery blood pressure. However, antihypertensive treatment based on brachial BP values reduces cardiovascular risk but cannot completely reverse the hypertension-induced risk of morbidity events. As is well known, BP varies in different arterial systems and invasive and non-invasive studies have demonstrated that brachial BP does not necessarily reflect central aortic BP. Emerging evidences now suggest that central pressure may predict cardiovascular diseases better than brachial BP; moreover, it may differently respond to certain antihypertensive drugs. The potential effects beyond peripheral BP control may be due to specific protective properties of different antihypertensive drugs in affecting central aortic pressure and arterial stiffness. Although data on direct cardiovascular benefit impact of central blood pressure treatment in randomized clinical trials are still lacking, it is likely that the improvement of quality of care and the individualized assessment of the hypertension-associated cardiovascular risk are achievable with the use of central hemodynamics. Therefore, basing antihypertensive treatment guidance on central pressures rather than on peripheral blood pressure may be the key for future antihypertensive strategies.

Cite this article as:

Rinaldi R. Elisa, Yannoutsos Alexandra, Borghi Claudio, Safar E. Michel and Blacher Jacques, Central Hemodynamics for Risk Reduction Strategies: Additive Value Over and Above Brachial Blood Pressure, Current Pharmaceutical Design 2015; 21 (6) . https://dx.doi.org/10.2174/1381612820666141023164530