title: The shape of the blood pressure curve and genetic hypertension.
abstract: Peak systolic pressure and end-diastolic pressure are two specific points of the blood pressure curve that are widely used and generally accepted to define hypertensive vascular disease. If the goal of research in hypertension, however, is to define high blood pressure as a mechanical signal related to cardiovascular risk through alterations of the arterial wall, then the totality of the blood pressure curve should be analyzed in detail. Fourier analysis indicates that the blood pressure curve may be divided into two components, a steady component, mean arterial pressure, and a pulsatile component, pulse pressure. For a given cardiac performance, the former is related to the caliber of small arteries and the latter to the mechanical properties of the large arteries. Whereas mean arterial pressure is practically unmodified along the arterial tree, pulse pressure increases markedly, owing to the progressive increase in pulse wave velocity and to the summation of forward and backward waves. This hemodynamic pattern is substantially modified with age, leading to various shapes and phenotypes of the blood pressure curve at any given value of mean arterial pressure. Such findings provide evidence that (a) the totality of the aortic blood pressure curve should be recorded in detail for genetic studies in experimental and human hypertension, and (b) the various phenotypic aspects of the blood pressure curve might influence the choice of the genetic markers that are used to study hypertensive vascular disease.
authors.affiliation: Michel E. Safar and Athanase Benetos are at the Department of Internal Medicine and INSERM (U337), Broussais Hospital, Paris, France.
authors.forename: M E
authors.initials: ME
authors.lastname: Safar
authors.forename: A
authors.initials: A
authors.lastname: Benetos