scholarly journals Central Aortic Blood Pressure and Pulse Wave Velocity as Tools in the Hemodynamic Assessment of Hypertension

2020 ◽  
Vol 6 (3) ◽  
pp. 147-154
Author(s):  
Isabella Tan ◽  
Mark Butlin ◽  
Fatemeh Shirbani ◽  
James R. Cox ◽  
Karen Peebles ◽  
...  
2018 ◽  
Vol 41 (7) ◽  
pp. 378-384 ◽  
Author(s):  
Alper Erdan ◽  
Abdullah Ozkok ◽  
Nadir Alpay ◽  
Vakur Akkaya ◽  
Alaattin Yildiz

Background: Arterial stiffness is a strong predictor of mortality in hemodialysis patients. In this study, we aimed to investigate possible relations of arterial stiffness with volume status determined by bioimpedance analysis and aortic blood pressure parameters. Also, effects of a single hemodialysis session on these parameters were studied. Methods: A total of 75 hemodialysis patients (M/F: 43/32; mean age: 53 ± 17) were enrolled. Carotid-femoral pulse wave velocity, augmentation index, and aortic pulse pressure were measured by applanation tonometry before and after hemodialysis. Extracellular fluid and total body fluid volumes were determined by bioimpedance analysis. Results: Carotid-femoral pulse wave velocity (9.30 ± 3.30 vs 7.59 ± 2.66 m/s, p < 0.001), augmentation index (24.52 ± 9.42 vs 20.28 ± 10.19, p < 0.001), and aortic pulse pressure (38 ± 14 vs 29 ± 8 mmHg, p < 0.001) significantly decreased after hemodialysis. Pre-dialysis carotid-femoral pulse wave velocity was associated with age (r2 = 0.15, p = 0.01), total cholesterol (r2 = 0.06, p = 0.02), peripheral mean blood pressure (r2 = 0.10, p = 0.005), aortic-mean blood pressure (r2 = 0.06, p = 0.02), aortic pulse pressure (r2 = 0.14, p = 0.001), and extracellular fluid/total body fluid (r2 = 0.30, p < 0.0001). Pre-dialysis augmentation index was associated with total cholesterol (r2 = 0.06, p = 0,02), aortic-mean blood pressure (r2 = 0.16, p < 0.001), and aortic pulse pressure (r2 = 0.22, p < 0.001). Δcarotid-femoral pulse wave velocity was associated with Δaortic-mean blood pressure (r2 = 0.06, p = 0.02) and inversely correlated with baseline carotid-femoral pulse wave velocity (r2 = 0.29, p < 0.001). Pre-dialysis Δaugmentation index was significantly associated with Δaortic-mean blood pressure (r2 = 0.09, p = 0.009) and Δaortic pulse pressure (r2 = 0.06, p = 0.03) and inversely associated with baseline augmentation index (r2 = 0.14, p = 0.001). In multiple linear regression analysis (adjusted R2 = 0.46, p < 0.001) to determine the factors predicting Log carotid-femoral pulse wave velocity, extracellular fluid/total body fluid and peripheral mean blood pressure significantly predicted Log carotid-femoral pulse wave velocity (p = 0.001 and p = 0.006, respectively). Conclusion: Carotid-femoral pulse wave velocity, augmentation index, and aortic pulse pressure significantly decreased after hemodialysis. Arterial stiffness was associated with both peripheral and aortic blood pressure. Furthermore, reduction in arterial stiffness parameters was related to reduction in aortic blood pressure. Pre-dialysis carotid-femoral pulse wave velocity was associated with volume status determined by bioimpedance analysis. Volume control may improve not only the aortic blood pressure measurements but also arterial stiffness in hemodialysis patients.


2018 ◽  
Vol 3 (5) ◽  
pp. 27-32
Author(s):  
O. V. Fedorishina ◽  
K. V. Protasov ◽  
A. M. Torunova

Background.Little is known about the effect of statins addition to standard antihypertensive therapy on blood pressure level and vascular stiffness in high-risk hypertensive patients.The aimof the study was to assess the dynamics of vascular stiffness in hypertensive patients of high or very high cardiovascular risk under the influence of rosuvastatin addition to combined two-component amlodipine and lisinopril antihypertensive therapy.Materials and methods.We investigated 60 hypertensive patients who were randomized into two groups: the 1st group received a fixed amlodipine/lisinopril combination, the 2nd one followed the same regimen of therapy with addition of 20 mg rosuvastatin. Mean office and ambulatory blood pressure as well as central aortic blood pressure and pulse wave velocity were evaluated in both groups before and after 24-week follow-up period.Results.At end of follow-up period the office and average daily blood pressure significantly decreased in both groups, with more prominent office diastolic blood pressure decline in the 2nd one. The central aortic blood pressure equally decreased in both groups. The augmentation index significantly reduced in both groups, mostly in the 2nd one. The carotid-femoral pulse wave velocity declined in both groups to the same extent. The carotid-radial pulse wave velocity decreased statistically only in the second group.Conclusions.Addition of rosuvastatin to a fixed amlodipine/lisinopril combination in high/very high cardiovascular risk hypertensive patients was accompanied by more pronounced decline of diastolic blood pressure and augmentation index, as well as significantly reduction of pulse wave velocity.


2017 ◽  
Vol 142 (19) ◽  
pp. 1430-1436 ◽  
Author(s):  
Martin Middeke

AbstractIn recent years great emphasis has been placed on the role of central aortic blood pressure as measured non invasively using pulse wave analysis in pathophysiology of cardiovascular diseases and clinical aspects of hypertension. The difference of blood pressure between the central aorta and the brachial artery (amplification) is not constant but varies according to physiological, pathological and pharmacological mechanisms. Central aortic blood pressure is more strongly related to cardiovascular organ damages than does brachial pressure. Several antihypertensive drugs have different effects on aortic blood pressure as compared with brachial pressure. Central aortic blood pressure emerges superior to brachial pressure as target blood pressure in antihypertensive treatment.


1952 ◽  
Vol 30 (2) ◽  
pp. 125-129
Author(s):  
J. P. Adamson ◽  
J. Doupe

Intra-arterial pressures and pulse wave velocities were measured in 18 subjects whose auscultatory diastolic pressures ranged from 45 to 120 mm. Hg. Various methods were used to lower the blood pressure in the hypertensive and to raise it in nonhypertensive subjects so that pulse wave velocities might be compared in all subjects at a common diastolic pressure. The pulse wave velocities were calculated for a diastolic pressure of 80 mm. Hg. No significant differences were found between hypertensive and nonhypertensive subjects. It was concluded that a defect of arterial elasticity as gauged by pulse wave velocity is not a factor in the pathogenesis of hypertension.


Sign in / Sign up

Export Citation Format

Share Document