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Arterial Stiffness, Wave Reflection, Wave Amplification: Basic Concepts, Principles of Measurement and Analysis in Humans

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Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases

Abstract

The arterial system has two functions – as a conduit to deliver blood at high pressure to the organs and tissues of the body according to need, and as a cushion, to reduce pulsations generated by the intermittently-pumping left ventricle, so that blood flow through peripheral high and low resistance vascular beds is steady with little residual pulsation (O’Rourke, Chapter 1: Principles and definitions of arterial stiffness, wave reflections and pulse pressure amplification. In: Safar ME, O’Rourke MF (eds) Arterial stiffness in hypertension. Handbook of hypertension, vol 23. Elsevier, Amsterdam, 2006; Nichols et al., McDonald’s blood flow in arteries, 6th edn. Arnold Hodder, London, 2011). The arterial system in man is beautifully suited to serve these functions, at least through childhood, adolescence and young adulthood (Taylor, Gastroenterology 52:358–363, 1967). By mid-life, effects of pulsatile strain on non-living elastic fibres in the highly pulsatile aorta lead to their fracture and to progressive passive aortic dilation, with transfer of stress to more rigid collagen fibres in the media (Nichols et al., McDonald’s blood flow in arteries, 6th edn. Arnold Hodder, London, 2011). Such changes have adverse effects on arterial function and ideal timing of vascular/ventricular interaction (O’Rourke and Nichols, Hypertension 45:652–658, 2005; Laurent et al., Eur Heart J 27:2588–2605, 2006; O’Rourke and Hashimoto, J Am Coll Cardiol 50:1–13, 2007). As later years pass, impaired arterial function plays an important role in morbidity and mortality, becoming a key factor in development of Isolated Systolic Hypertension of the Elderly (ISHE), and cardiac failure (Chirinos et al. 2012; Weber et al. 2013) and of cerebral micro-infarcts and hemorrhage with cognitive impairment and dementia (O’Rourke and Safar ME, Hypertension 46:200–204, 2005; Stone, Med Hypotheses 71:347–359, 2008; Gorelick, Stroke 42:2672–2713, 2011). This introductory chapter discusses mechanisms and introduces strategies for treatment and prevention.

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Author information

Authors and Affiliations

  1. Department of Cardiovascular and Hypertension, St Vincent’s Clinic, University of New South Wales, Victor Chang Cardiac Research Institute, Suite 810 St Vincent Clinic, 438 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia

    Michael F. O’Rourke MD, DSc

  2. Harvard-MIT Biomedical Engineering Center, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA, 02139, USA

    Caroline O’Brien PhD

  3. Department of Cardiology, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, Wels, 4600, Austria

    Thomas Weber MD

  4. Paracelsus Medical University, Salzburg, Austria

    Thomas Weber MD

Authors
  1. Michael F. O’Rourke MD, DSc
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  2. Caroline O’Brien PhD
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  3. Thomas Weber MD
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Corresponding author

Correspondence to Michael F. O’Rourke MD, DSc .

Editor information

Editors and Affiliations

  1. Hôtel-Dieu Hospital Diagnosis and Therapeutics Center, Paris Descartes University, Paris, Paris, France

    Michel E. Safar

  2. St Vincent Clinic and Hospital, University of New South Wales, Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia

    Michael F. O'Rourke

  3. Department of Cardiology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA

    Edward D. Frohlich

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O’Rourke, M.F., O’Brien, C., Weber, T. (2014). Arterial Stiffness, Wave Reflection, Wave Amplification: Basic Concepts, Principles of Measurement and Analysis in Humans. In: Safar, M., O'Rourke, M., Frohlich, E. (eds) Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases. Springer, London. https://doi.org/10.1007/978-1-4471-5198-2_1

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  • DOI: https://doi.org/10.1007/978-1-4471-5198-2_1

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