Document Detail


Arterial stiffness and central hemodynamics in treated hypertensive subjects according to brachial blood pressure classification.
MedLine Citation:
PMID:  18090550     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: International recommendations have classified brachial blood pressure (BP) in subgroups enabling better cardiovascular risk stratification. Central BP is an independent predictor of cardiovascular risk, differing from brachial BP through the predominant influence of arterial stiffness and wave reflections. Central BP has never been studied in relation to international guidelines for brachial BP classification. METHODS: In 580 chronically treated hypertensive subjects we measured: carotid-femoral pulse wave velocity (PWV), carotid artery augmentation index (AI) and carotid blood pressures, using applanation tonometry and pulse wave analysis, and using brachial BP for carotid pressure wave calibration. RESULTS: For each given brachial value, carotid systolic blood pressure (SBP) and PP were significantly lower than the corresponding brachial SBP and PP. This pressure amplification was significantly lower in the 'optimal' and 'normal' BP ranges (6.8-7.4 mmHg) than in the higher BP ranges (10.1-11.3 mmHg), mainly depending on heart rate (HR) and PWV levels. PWV gradually increased as a function of brachial BP classification and was a significant predictor of this classification independently of age, drug treatment, atherosclerotic lesions and even mean BP. Finally, PWV was a highly sensitive marker of the effective BP control throughout all decades of age. CONCLUSION: Under chronic antihypertensive therapy, central BP does not strictly parallel the corresponding brachial BP classification, depending on differences in aortic stiffness and HR. Whether aortic PWV might predict the brachial BP classification and/or the presence of effective BP control, as suggested in this study, needs further confirmation.
Authors:
Michel E Safar; Jacques Blacher; Athanase Protogerou; Apostolos Achimastos
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  26     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  130-7     Citation Subset:  IM    
Affiliation:
AP-HP Diagnosis Center, Hôtel-Dieu Hospital, Faculty of Medicine, Paris-Descartes University, Paris, France. michel.safarhtd.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use*
Arteries / drug effects,  physiopathology*
Blood Pressure / drug effects*
Brachial Artery / physiopathology*
Carotid Arteries / physiopathology
Cohort Studies
Female
Femoral Artery / physiopathology
Hemodynamics / drug effects*
Humans
Hypertension / classification,  drug therapy,  physiopathology*
Male
Middle Aged
Multivariate Analysis
Pulsatile Flow
Risk Factors
Sensitivity and Specificity
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
J Hypertens. 2008 Jan;26(1):16-7   [PMID:  18090535 ]

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