#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Perspectives on central systolic pressure in clinical practice


Authors: Mária Potočárová 1;  Jozef Bulas 1;  Viera Kupčová 2;  Marta Filková 1;  Ján Murín 1
Authors place of work: I. Interná klinika LF UK a UNB, Bratislava 1;  III. interná klinika LF UK a UNB, Bratislava 2
Published in the journal: AtheroRev 2018; 3(1): 29-33
Category: Reviews

Summary

The basic characteristic of blood circulation in humans is given by the cyclical work of the heart, which ejects the blood pulse volume into the arteries. The workload of left ventricle can be in a simple way defined as the energy needed to expel blood flow to the aorta. In hypertension, also the arterial tree is exposed to increased mechanical load, because it absorbs the energy of pulse work associated with pulsatile blood flow. Higher vascular wall stress result in the acceleration of degenerative changes. These changes are involved in further increasing stiffness of the arteries and increasing static and dynamic left ventricular load by increasing systolic pressure in the ascending aorta. Higher mechanical load of the arteries accelerates the process of atherosclerosis and arteriosclerosis and increases the risk of rupture of atherosclerotic plaques with subsequent manifestation of serious cardiovascular complications. Central systolic blood pressure (CSBP), i.e. blood pressure in the aorta, directly affects the perfusion of critical organs – brain, heart and kidneys. The results of several clinical trials confirm that CSBP has a more important prognostic effect than blood pressure measured on brachial artery and is therefore a better predictor of cardiovascular events. Significantly correlates with the presence of organ damage as well as an estimated cardiovascular risk, although not all opinions are consistent with this view. The inclusion of CSBP measurement in routine practice requires further validation of the measurement methodologies and reference values. So far, the use of systolic blood pressure amplification indexes as well as central blood pressure values as a target of antihypertensive treatment remains unclear.

Key words:
cardiovascular risk, central blood pressure, pressure amplification

Received:
8. 1. 2018

Accepted:
22. 1. 2018


Zdroje

1. Mancia G, De Backer G, Dominiczak A et al. Guidelines for the management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) amd of the European Society od Cardiology (ESC). Eur Heart J 2007; 28(12): 1462–1536. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehm236>.

2. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for themanagement of arterial hypertension. The Task Force for the management of arterial hypertension European Society ofHypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31(7): 1281 – 1357. Dostupné z DOI: <http://dx.doi.org/10.1097/01.hjh.0000431740.32696.cc>.

3. Kannel W. Elevated systolic blood pressure as a cardiovascular risk factor. Am J Cardiol 2000; 85(2):251–255.

4. McEniery C, Cockcroft JR, Roman MJ et al. Central blood pressure: current evidence and clinical importance. Eur Heart J 2014; 35(26): 1719–1725. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/eht565>.

5. Wright JT Jr, Williamson JD, Whelton PK. [SPRINT Research Group]. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015; 373(22): 2103–16. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1511939>.

6. Perkovic V, Rodgers A. Redefining Blood-Pressure Targets — SPRINT Starts the Marathon. N Engl J Med 2015; 373(22): 2175–2178. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMe1513301>.

7. Berlowitz DR, Foy CG, Kazis LE et al. [SPRINT Research Group]. Effect of Intensive Blood-Pressure Treatment on Patient-Reported Outcomes. N Engl J Med 2017; 377(8): 733–744. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611179>.

8. Whelton P, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2017. In press. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2017.11.005>.

9. London G. Brachial arterial pressure to assess cardiovascular structural damage: an overview and lessons from clinical trials. J Nephrol 2008; 21(1): 23–31.

10. Cheng H, Chuang S, Sung S et al. Derivation and validation of diagnostic thresholds for central blood pressure blood pressure measuremtns based on log-term cardiovascular risks. J Am Coll Cardiol 2013; 62(19): 1780–1787. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2013.06.029>.

11. Herbert A, Cruickshank S, Laurent S et al. Establishing reference values for central blood pressure and its amplification in a general healthy populatiuon and according to cardiovascular risk factors. Eur Heart J 2014; 35(44): 3122–3133. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehu293>.

12. Bulas J, Potočárová M, Murín J et al. Central Systolic Hypertension in Patients with Well-Controlled Hypertension. Biomed Res Int 2017; 2017: 8158974. Dostupné z DOI: <http://dx.doi.org/10.1155/2017/8158974>.

13. Williams B, Lacy P. Central aortic pressure and clinical outcomes. J Hypertens 2009; 27(6): 1123–1125. Dostupné z DOI: <http://dx.doi.org/10.1097/HJH.0b013e32832b6566>.

14. Nichols W, O´Rourke M, Vlachopoulos C. McDonald´s Blood Flow in Arteries. Theoretical, experimetal and clinical principles. Hodden Arnold: London2011. 6th ed. ISBN-13 978–0–340–985–014.

15. Safar M, Jankowski P. Central blood pressure and hypertension: role in cardiovascular risk assessment. Clinical Science 2009; 116(4): 273–282. Dostupné z DOI: <http://dx.doi.org/10.1042/CS20080072>.

16. Safar M, Blacher J, Pannier B et al. Central pulse pressure and mortality in end-stage renal disease. Hypertension 2002; 39(3): 735–738.

17. Roman M, Devereux RB, Kizer JR et al. High central pulse pressure is independently associated with adverse cardiovascular outcome the strong heart study. J Am Coll Cardiol 2009; 54(18): 1730–1734. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2009.05.070>.

18. Vlachopoulos C, Aznaouridis K, O'Rourke MF et al. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J 2010; 31(15): 1865–1871. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehq024>.

19. Mitchell G. Central pressure should not be used in clinical practice. Artery Res 2015; 9: 8–13. Dostupné z DOI: <http://dx.doi.org/10.1016/j.artres.2014.11.002>.

20. Lindholm L, Ibsen H, Dahlöf B et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359(9311): 1004–1010. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(02)08090-X>.

21. Dahlof B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT). Lancet 2005; 366(9489): 895–906. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(05)67185–1>.

22. Asmar R, London GM, O'Rourke ME et al. Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide combination in hypertensive patient: a comparison with atenolol. Hypertension 2001; 38(4): 922–926.

23. Deary A, Schumann AL, Murfet H et al.Influence of drugs and gender on the arterial pulse wave and natriuretic peptide secretionin untreated patients with essential hypertension. Clin Sci 2002; 103(5): 493–499. Dostupné z DOI: <http://dx.doi.org/10.1042/>.

24. Williams B, Lacy PS, Thom SM et al. Differential impact of blood pressure lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113(9): 1213–1225. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.105.595496>.

25. Rinaldi E, Yannoutsos A, Borghi C et al. Central Hemodynamics for Risk Reduction Strategies: Additive Value Over and Above Brachial Blood Pressure. Curr Pharm Des 2015; 21(6): 730–736.

26. Kollias A, Lagou S, Zeniodi ME et al. Association of Central Versus Brachial Blood Pressure With Target-Organ Damage: Systematic Review and Meta-Analysis. Hypertension 2016; 67(1): 183–190. Dostupné z DOI: <http://dx.doi.org/10.1161/HYPERTENSIONAHA.115.06066>.

27. Kaess B, Rong J, Larson MG et al. Relations of Central Hemodynamics and Aortic Stiffness with Left Ventricular Structure and Function: The Framingham Heart Study. J Am Heart Assoc 2016; 5(3): e002693. Dostupné z DOI: <http://dx.doi.org/10.1161/JAHA.115.002693>. Erratum in Relations of Central Hemodynamics and Aortic Stiffness with Left Ventricular Structure and Function: The Framingham Heart Study. [J Am Heart Assoc 2016].

28. De Luca N, Asmar RG, London GM et al. Selective reduction of cardiac mass and central blood pressure on low-dose combination perindopril/indapamide in hypertensive subjects. J Hypertens 2004; 22(8): 1623–1630.

Štítky
Angiology Diabetology Internal medicine Cardiology General practitioner for adults
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#