This Article Free upon publication Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Oparil, S. Articles by Izzo, J. L. Search for Related Content PubMed PubMed Citation Articles by Oparil, S. Articles by Izzo, J. L., Jr Related Collections Clinical Studies

(Circulation. 2006;113:1162-1163.)
© 2006 American Heart Association, Inc.

Editorial

Pulsology Rediscovered

Commentary on the Conduit Artery Function Evaluation (CAFE) Study

Suzanne Oparil, MD; Joseph L. Izzo, Jr, MD

From the Vascular Biology and Hypertension Program (S.O.), Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, and Erie County Medical Center and the Division of Clinical Pharmacology (J.L.I.), Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY.

Correspondence to Suzanne Oparil, MD, Vascular Biology and Hypertension Program, University of Alabama at Birmingham, 703 19th St S, ZRB 1034, Birmingham, AL 35294-0007. E-mail soparil@uab.edu

Key Words: Editorials • blood pressure • hypertension

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Nearly everything that modern practicing clinicians know about hypertension and its treatment is based on simple noninvasive measurement of brachial artery blood pressure. As the study by Williams and colleagues¹ illustrates, however, additional knowledge of pulse-wave characteristics may be important in the future to fully assess optimal cardiovascular drug therapy.

The study of pulse-wave characteristics is far older than the study of absolute pressure values, dating back thousands of years to the Chinese masters who used their fingertips and their powers of observation to associate "hardening of the pulse" with adverse outcomes in people who ingested too much salt. These qualitative observations were less well developed in Western medicine, but as early as the 1870s, the sphygmocardiogram was developed as a reproduction of a peripheral pulse wave on a rotating drum via a tonometer attached to a levered stylus.^1a Morrell and other early investigators were clearly able to differentiate the effects of nitrovasodilators from digitalis using this early equipment, but interpretations remained largely qualitative. Within a few decades, the development of sphygmomanometry by Korotkovand Riva-Rocci allowed quantitation of brachial cuff blood pressures, and the more descriptive methods largely disappeared.

Article p 1213

Indeed, brachial cuff blood pressure has become an enduring clinical variable. Actuarial data from the life insurance industry and subsequent prospective observational data have clearly shown that hypertension, or elevated cuff blood pressure, is closely related to many forms of cardiovascular disease.^2–4 Most recently, a very large meta-analysis by the Prospective Studies Collaborators that involved almost 1 million . . . [Full Text of this Article]

This article has been cited by other articles:

				J. Andrade, L. Er, A. Ignaszewski, and A. Levin Exploration of Association of 1,25-OH2D3 with Augmentation Index, a Composite Measure of Arterial Stiffness Clin. J. Am. Soc. Nephrol., November 1, 2008; 3(6): 1800 - 1806. [Abstract] [Full Text] [PDF]

				R. D. Smith and P. J. Levy Review: New techniques for assessment of vascular function Therapeutic Advances in Cardiovascular Disease, October 1, 2008; 2(5): 373 - 385. [Abstract] [PDF]

				V. Palmieri, R. Pini, and M. Chiara Cavallini Pulsology Reloaded: Commentary on Similar Effects of Treatment on Central and Brachial Blood Pressure in Older Hypertensive Subjects Hypertension, June 1, 2007; 49(6): 1210 - 1212. [Full Text] [PDF]

				A. M. Dart, C. D. Gatzka, and B. Kingwell Letter by Dart et al Regarding Article, "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, October 10, 2006; 114(15): e537 - e537. [Full Text] [PDF]

				J. D. Cameron, I. T. Meredith, and S. A. Hope Letter by Cameron et al Regarding Article, "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, October 10, 2006; 114(15): e538 - e538. [Full Text] [PDF]

				B. Williams, P. S. Lacy, H. Thurston, S. Thom, A. Hughes, K. Cruickshank, A. Stanton, D. Collier, and M. O'Rourke Response to Letters Regarding Article, "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, October 10, 2006; 114(15): e540 - e541. [Full Text] [PDF]