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Eur Heart J. 2014 Jul;35(26):1719-25. doi: 10.1093/eurheartj/eht565. Epub 2014 Jan 23.

Central blood pressure: current evidence and clinical importance.

Author information

1
Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Box 110, Cambridge CB2 2QQ, UK cmm41@cam.ac.uk.
2
Department of Cardiology, Wales Heart Research Institute, Cardiff CF14 4XN, UK.
3
Division of Cardiology, Weill Cornell Medical College, New York, NY 10021, USA.
4
University of California, UCI School of Medicine, Irvine, CA 92697-4101, USA.
5
Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Box 110, Cambridge CB2 2QQ, UK.

Abstract

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.

KEYWORDS:

Anti-hypertensive treatment; Blood pressure; Cardiovascular risk; Central pressure

PMID:
24459197
PMCID:
PMC4155427
DOI:
10.1093/eurheartj/eht565
[Indexed for MEDLINE]
Free PMC Article
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