TY - JOUR
T1 - Central blood pressure
T2 - Current evidence and clinical importance
AU - McEniery, Carmel M.
AU - Cockcroft, John R.
AU - Roman, Mary J.
AU - Franklin, Stanley S.
AU - Wilkinson, Ian B.
PY - 2014/7/7
Y1 - 2014/7/7
N2 - Pressure measured with a cuff and sphygmomanometer in the brachial artery is accepted as an important predictor of future cardiovascular risk. However, systolic pressure varies throughout the arterial tree, such that aortic (central) systolic pressure is actually lower than corresponding brachial values, although this difference is highly variable between individuals. Emerging evidence now suggests that central pressure is better related to future cardiovascular events than is brachial pressure. Moreover, anti-hypertensive drugs can exert differential effects on brachial and central pressure. Therefore, basing treatment decisions on central, rather than brachial pressure, is likely to have important implications for the future diagnosis and management of hypertension. Such a paradigm shift will, however, require further, direct evidence that selectively targeting central pressure, brings added benefit, over and above that already provided by brachial artery pressure.
AB - Pressure measured with a cuff and sphygmomanometer in the brachial artery is accepted as an important predictor of future cardiovascular risk. However, systolic pressure varies throughout the arterial tree, such that aortic (central) systolic pressure is actually lower than corresponding brachial values, although this difference is highly variable between individuals. Emerging evidence now suggests that central pressure is better related to future cardiovascular events than is brachial pressure. Moreover, anti-hypertensive drugs can exert differential effects on brachial and central pressure. Therefore, basing treatment decisions on central, rather than brachial pressure, is likely to have important implications for the future diagnosis and management of hypertension. Such a paradigm shift will, however, require further, direct evidence that selectively targeting central pressure, brings added benefit, over and above that already provided by brachial artery pressure.
KW - Anti-Hypertensive treatment
KW - Blood pressure
KW - Cardiovascular risk
KW - Central pressure
UR - http://www.scopus.com/inward/record.url?scp=84911932134&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/eht565
DO - 10.1093/eurheartj/eht565
M3 - Review article
C2 - 24459197
AN - SCOPUS:84911932134
VL - 35
SP - 1719
EP - 1725
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 26
ER -