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Central blood pressure, arterial stiffness, and wave reflection: New targets of treatment in essential hypertension

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Abstract

Central blood pressure is dependent on the stiffness of large arteries and pulse wave reflection. These parameters are very important in the development of hypertensive target organ disease. Moreover, recent clinical studies have shown their independent predictive value for cardiovascular morbidity and mortality. Therefore, 2007 guidelines for the management of hypertension inserted the evaluation of central arterial stiffness as an important component for assessing total cardiovascular risk. Differences in the way various antihypertensive drugs affect arterial stiffness and central hemodynamics may explain the greater cardiovascular protection provided by newer drugs (eg, renin-angiotensin system blockers or calcium channel blockers) independent of peripheral blood pressure reduction, as shown by recent clinical studies. However, the predictive value of the attenuation of arterial stiffness, wave reflections, and central blood pressure still needs to be confirmed in prospective, long-term, large-scale therapeutic trials. Thus, whether these measurements should be routinely performed as a diagnostic or therapeutic indicator remains debatable.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy

    Stefano Taddei

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  1. Lorenzo Ghiadoni
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  2. Rosa Maria Bruno
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  3. Francesco Stea
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  4. Agostino Virdis
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  5. Stefano Taddei
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Correspondence to Stefano Taddei.

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Ghiadoni, L., Bruno, R.M., Stea, F. et al. Central blood pressure, arterial stiffness, and wave reflection: New targets of treatment in essential hypertension. Current Science Inc 11, 190–196 (2009). https://doi.org/10.1007/s11906-009-0034-5

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