[Placebo effect on diastolic, systolic and pulsed arterial pressure].
THE PLACEBO EFFECT: In controlled clinical trials, use of a placebo has demonstrated that the lowering of blood pressure in hypertensive patients under medication is associated with a reduction in cardiovascular morbidity and mortality. Although a placebo clearly lowers levels of systolic and diastolic blood pressure (to varying degrees depending on the measurement used), it does not appear to have any effect on the pulse pressure, representing the difference between the systolic and diastolic pressures. CENTRAL MECHANISMS: The absence of placebo effect on the pulse pressure, demonstrated by controlled studies, suggests the activity of central mechanisms (notably bulbar), common to the placebo effect and to the control of neurogenic coupling between the heart and the large caliber arteries.


CONCLUSIONS
Since the pulse pressure after the age of 60 is a major factor for predicting myocardial infarction, these results suggest that modifications in pulse pressure should be more closely studied during controlled cardiovascular clinical trials in elderly patients.
Queneau
P
P
Hôpital Bellevue, Service de Médecine interne et thérapeutique, CHU, Boulevard Pasteur, 42055 Saint-Etienne. patrice.queneau@chu-stetienne.fr
Asmar
R
R
Safar
M
M
D001794:Blood Pressure / Q000502:physiology; D001933:Brain Stem / Q000502:physiology; D002986:Clinical Trials as Topic; D003971:Diastole / Q000502:physiology; D006321:Heart / Q000294:innervation; D006801:Humans; D015990:Placebo Effect; D011674:Pulse; D013599:Systole / Q000502:physiology