title: Beyond conventional considerations: newer devices used in blood pressure measurement and management.
abstract: Several noninvasive devices are now available to assess blood vessel structure and function and have been shown in longitudinal cohort studies to provide additional cardiovascular event prediction over that obtained by conventional brachial blood pressure (BP) measurements. Among these newer measurements are estimates of vascular stiffness (as determined by the pulse wave velocity in the aorta) and measures of pulse wave reflection. Pulse wave velocity, in particular, has been well studied in end-stage kidney (ESKD) populations where it predicts cardiovascular events and death independently of standard BP. In addition, there are minimum 3 devices, either marketed or used in clinical trials, that are useful in some clinical situations as an adjunct to drug therapy for managing high BP. This review will focus on the roles of these new technologies in evaluating and managing high BP, emphasizing the CKD/ESKD patient where possible, although data are limited in the kidney disease population when it comes to managing BP with these novel device approaches.
authors.affiliation: Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Virginia Commonwealth University Health System, Richmond, VA, USA. townsend@exchange.upenn.edu
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Townsend
authors.forename: Domenic A
authors.initials: DA
authors.lastname: Sica
mesh_terms: D001158:Arteries / Q000503:physiopathology; D017704:Baroreflex / Q000502:physiology; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods; D001945:Breathing Exercises; D017115:Catheter Ablation / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D011379:Prognosis; D011673:Pulsatile Flow; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods*