Effects of arterial stiffness, pulse wave velocity, and wave reflections on the central aortic pressure waveform

Wilmer W. Nichols*, Scott J. Denardo, Ian B. Wilkinson, Carmel M. McEniery, John Cockcroft, Michael F. O'Rourke

*Corresponding author for this work

Research output: Contribution to journalReview article

121 Citations (Scopus)

Abstract

Brachial systolic and pulse blood pressures (BPs) are better predictors of adverse cardiovascular (CV) events than diastolic BP in individuals older than 50 years. The principal cause of increased systolic and pulse BP is increased stiffness of the elastic arteries as a result of degeneration and hyperplasia of the arterial wall. Recent studies have shown that central BP, the pressure exerted on the heart, brain, and kidneys, is a better predictor of CV risk than brachial BP. As stiffness increases, reflected wave amplitude increases and augments pressure in late systole, producing an increase in left ventricular afterload and myocardial oxygen demand. Vasoactive drugs have little direct effect on large human elastic arteries but can markedly modify wave reflection by altering stiffness of the muscular arteries and changing pulse wave velocity of the reflected wave from the periphery to the heart. Vasodilators decrease the amplitude and increase the travel time (or delay) of the reflected wave, causing a generalized decrease in systolic BP. The decrease in systolic BP brought about by this mechanism is grossly underestimated when systolic BP is measured in the brachial artery. J Clin Hypertens (Greenwich). 2008;10:295-303.

Original languageEnglish
Pages (from-to)295-303
Number of pages9
JournalJournal of Clinical Hypertension
Volume10
Issue number4
DOIs
Publication statusPublished - Apr 2008

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    Nichols, W. W., Denardo, S. J., Wilkinson, I. B., McEniery, C. M., Cockcroft, J., & O'Rourke, M. F. (2008). Effects of arterial stiffness, pulse wave velocity, and wave reflections on the central aortic pressure waveform. Journal of Clinical Hypertension, 10(4), 295-303. https://doi.org/10.1111/j.1751-7176.2008.04746.x