Circulation. 2003;107:2864-2869
doi: 10.1161/01.CIR.0000069826.36125.B4
doi: 10.1161/01.CIR.0000069826.36125.B4
(Circulation. 2003;107:2864.)
© 2003 American Heart Association, Inc.
Special Review: Current Perspective |
Current Perspectives on Arterial Stiffness and Pulse Pressure in Hypertension and Cardiovascular Diseases
From the Department of Internal Medicine (M.E.S.), Broussais Hospital, Paris, France; Lariboisiere Hospital (B.I.L.), Department of Physiology and Clinical Investigation, Paris, France; and Department of Pharmacology (H.S.-B.), Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands.
Correspondence to Professor Michel Safar, Médecine Interne 1 Groupe Hospitalier Broussais-G Pompidou 96, rue Didot, 75674 Paris, Cedex 14, France. E-mail michel.safar@brs.ap-hop-paris.fr
Key Words: arteries • elasticity • hypertension • mechanics • survival
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Blood pressure (BP) is a powerful cardiovascular (CV) risk factor that acts on the arterial wall and is responsible in part for various CV events, such as cerebrovascular accidents and ischemic heart disease. In clinical practice, 2 specific and arbitrary points of the BP curve, peak systolic BP (SBP) and end-diastolic BP (DBP), are used to define the CV risk factor. Because the goal of drug treatment of hypertension is to prevent CV complications, it appears likely that the totality of the BP curve, not simply 2 specific and arbitrary points, should be considered to act mechanically on the arterial wall and therefore should be used to propose an adequate definition of high BP.
A current approach consists of considering the BP curve as the summation of a steady component, mean blood pressure (MBP), and a pulsatile component, pulse pressure (PP).1 MBP, the product of cardiac output multiplied by total peripheral resistance, is the pressure for the steady flow of blood and oxygen to peripheral tissues and organs. The pulsatile component, PP, is the consequence of intermittent ventricular ejection from the heart. PP is influenced by several cardiac and vascular factors, but it is the role of large conduit arteries, mainly the aorta, to minimize pulsatility. In addition to the pattern of left ventricular ejection, the determinants of PP (and SBP) are the cushioning capacity of arteries and the timing and intensity of wave reflections.1 The former is influenced by arterial stiffness, usually expressed in the quantitative terms of compliance
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J. M. Dijk, A. Algra, Y. van der Graaf, D. E. Grobbee, M. L. Bots, and on behalf of the SMART study group Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study Eur. Heart J., June 2, 2005; 26(12): 1213 - 1220. [Abstract] [Full Text] [PDF]
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Y. Ichigi, H. Takano, K. Umetani, K. Kawabata, J.-e. Obata, Y. Kitta, Y. Kodama, A. Mende, T. Nakamura, D. Fujioka, et al. Increased Ambulatory Pulse Pressure Is a Strong Risk Factor for Coronary Endothelial Vasomotor Dysfunction J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1461 - 1466. [Abstract] [Full Text] [PDF]
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R. S. Reneman, J. M. Meinders, and A. P.G. Hoeks Non-invasive ultrasound in arterial wall dynamics in humans: what have we learned and what remains to be solved Eur. Heart J., May 2, 2005; 26(10): 960 - 966. [Abstract] [Full Text] [PDF]
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S. J. Zieman, V. Melenovsky, and D. A. Kass Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness Arterioscler Thromb Vasc Biol, May 1, 2005; 25(5): 932 - 943. [Abstract] [Full Text] [PDF]
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 I. Ferreira, R. M. A. Henry, J. W. R. Twisk, W. van Mechelen, H. C. G. Kemper, and C. D. A. Stehouwer The Metabolic Syndrome, Cardiopulmonary Fitness, and Subcutaneous Trunk Fat as Independent Determinants of Arterial Stiffness: The Amsterdam Growth and Health Longitudinal Study Arch Intern Med, April 25, 2005; 165(8): 875 - 882. [Abstract] [Full Text] [PDF]
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C. Giannattasio, M. Failla, S. Lucchina, C. Zazzeron, V. Scotti, A. Capra, L. Viscardi, F. Bianchi, G. Vitale, M. Lanzetta, et al. Arterial Stiffening Influence of Sympathetic Nerve Activity: Evidence From Hand Transplantation in Humans Hypertension, April 1, 2005; 45(4): 608 - 611. [Abstract] [Full Text] [PDF]
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J. C. Verhave, P. Fesler, G. du Cailar, J. Ribstein, M. E. Safar, and A. Mimran Elevated Pulse Pressure Is Associated With Low Renal Function in Elderly Patients With Isolated Systolic Hypertension Hypertension, April 1, 2005; 45(4): 586 - 591. [Abstract] [Full Text] [PDF]
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M. F. O'Rourke and W. W. Nichols Aortic Diameter, Aortic Stiffness, and Wave Reflection Increase With Age and Isolated Systolic Hypertension Hypertension, April 1, 2005; 45(4): 652 - 658. [Full Text] [PDF]
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 M. Diamant, H. J. Lamb, M. A. van de Ree, E. L. Endert, Y. Groeneveld, M. L. Bots, P. J. Kostense, and J. K. Radder The Association between Abdominal Visceral Fat and Carotid Stiffness Is Mediated by Circulating Inflammatory Markers in Uncomplicated Type 2 Diabetes J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1495 - 1501. [Abstract] [Full Text] [PDF]
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C. A. Boreham, I. Ferreira, J. W. Twisk, A. M. Gallagher, M. J. Savage, and L. J. Murray Cardiorespiratory Fitness, Physical Activity, and Arterial Stiffness: The Northern Ireland Young Hearts Project Hypertension, November 1, 2004; 44(5): 721 - 726. [Abstract] [Full Text] [PDF]
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P. Ou, D. Bonnet, L. Auriacombe, E. Pedroni, F. Balleux, D. Sidi, and E. Mousseaux Late systemic hypertension and aortic arch geometry after successful repair of coarctation of the aorta Eur. Heart J., October 2, 2004; 25(20): 1853 - 1859. [Abstract] [Full Text] [PDF]
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 A. Tivesten, A. Barlind, K. Caidahl, N. Klintland, A. Cittadini, C. Ohlsson, and J. Isgaard Growth hormone-induced blood pressure decrease is associated with increased mRNA levels of the vascular smooth muscle KATP channel J. Endocrinol., October 1, 2004; 183(1): 195 - 202. [Abstract] [Full Text] [PDF]
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P. Lacolley Mechanical influence of cyclic stretch on vascular endothelial cells Cardiovasc Res, September 1, 2004; 63(4): 577 - 579. [Full Text] [PDF]
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M. E. Safar Peripheral Pulse Pressure, Large Arteries, and Microvessels Hypertension, August 1, 2004; 44(2): 121 - 122. [Full Text] [PDF]
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G. F. Mitchell, H. Parise, E. J. Benjamin, M. G. Larson, M. J. Keyes, J. A. Vita, R. S. Vasan, and D. Levy Changes in Arterial Stiffness and Wave Reflection With Advancing Age in Healthy Men and Women: The Framingham Heart Study Hypertension, June 1, 2004; 43(6): 1239 - 1245. [Abstract] [Full Text] [PDF]
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M. F. O'Rourke, M. E. Safar, W. W. Nichols, G. F. Mitchell, J. L. Izzo Jr, Y. Lacourciere, J.-P. Ouellet, J. Neutel, L. J. Kerwin, A. J. Block, et al. Proximal Aortic Diameter and Aortic Pressure-Flow Relationship in Systolic Hypertension * Response Circulation, May 25, 2004; 109(20): e227 - e228. [Full Text] [PDF]
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J. B. Seward, M. F. O'Rourke, M. M. Budge, and R. G. Gosling Terminology for Describing the Elastic Behavior of Arteries * Response: Terminology for Describing the Elastic Behavior of Arteries Hypertension, April 1, 2004; 43(4): e25 - e26. [Full Text] [PDF]
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S. M.T. Hughes, L. J. Dixon, G. E. McVeigh, M. E. Safar, B. I. Levy, and H. Struijker-Boudier Arterial Stiffness and Pulse Wave Velocity: Problems with Terminology * Response Circulation, January 20, 2004; 109 (2): e3 - e3. [Full Text] [PDF]
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A. D. Stewart, S. C. Millasseau, M. T. Kearney, J. M. Ritter, and P. J. Chowienczyk Effects of Inhibition of Basal Nitric Oxide Synthesis on Carotid-Femoral Pulse Wave Velocity and Augmentation Index in Humans Hypertension, November 1, 2003; 42(5): 915 - 918. [Abstract] [Full Text] [PDF]
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