Central blood pressures: do we need them in the management of cardiovascular disease? Is it a feasible therapeutic target?
It is well established that in young and healthy individuals central (aortic or carotid) systolic and pulse pressures are different from peripheral (brachial) corresponding pressures as a consequence of progressive changes in arterial stiffness and pressure wave reflections along the arterial tree. There is evidence indicating that in interventions with pharmaceutical and non-pharmaceutical agents, central pressures are subjected to greater changes than peripheral pressures, and they are more closely related to the pathophysiology of end-organ damage or cardiovascular risk. Therefore central blood pressures may be of higher clinical importance than peripheral pressures. The present review aims to provide an insight into the (patho)physiology of central blood pressures, to present the most accurate techniques for their estimation, and to discuss the available experimental and epidemiological data that support the emerging need for the evaluation of central blood pressures in clinical practice.
Protogerou
Athanase D
AD
Diagnostic and Therapeutic Center, Hôtel-Dieu Hospital, Paris, France.
Papaioannou
Theodore G
TG
Blacher
Jacques
J
Papamichael
Christos M
CM
Lekakis
John P
JP
Safar
Michel E
ME
D001011:Aorta / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D011674:Pulse; D014655:Vascular Resistance / Q000502:physiology; D014665:Vasodilator Agents / Q000494:pharmacology
D014665:Vasodilator Agents