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Perspectives on central systolic pressure in clinical practice


Authors: Mária Potočárová 1;  Jozef Bulas 1;  Viera Kupčová 2;  Marta Filková 1;  Ján Murín 1
Authors‘ workplace: I. Interná klinika LF UK a UNB, Bratislava 1;  III. interná klinika LF UK a UNB, Bratislava 2
Published in: AtheroRev 2018; 3(1): 29-33
Category: Reviews

Overview

The basic characteristic of blood circulation in humans is given by the cyclical work of the heart, which ejects the blood pulse volume into the arteries. The workload of left ventricle can be in a simple way defined as the energy needed to expel blood flow to the aorta. In hypertension, also the arterial tree is exposed to increased mechanical load, because it absorbs the energy of pulse work associated with pulsatile blood flow. Higher vascular wall stress result in the acceleration of degenerative changes. These changes are involved in further increasing stiffness of the arteries and increasing static and dynamic left ventricular load by increasing systolic pressure in the ascending aorta. Higher mechanical load of the arteries accelerates the process of atherosclerosis and arteriosclerosis and increases the risk of rupture of atherosclerotic plaques with subsequent manifestation of serious cardiovascular complications. Central systolic blood pressure (CSBP), i.e. blood pressure in the aorta, directly affects the perfusion of critical organs – brain, heart and kidneys. The results of several clinical trials confirm that CSBP has a more important prognostic effect than blood pressure measured on brachial artery and is therefore a better predictor of cardiovascular events. Significantly correlates with the presence of organ damage as well as an estimated cardiovascular risk, although not all opinions are consistent with this view. The inclusion of CSBP measurement in routine practice requires further validation of the measurement methodologies and reference values. So far, the use of systolic blood pressure amplification indexes as well as central blood pressure values as a target of antihypertensive treatment remains unclear.

Key words:
cardiovascular risk, central blood pressure, pressure amplification

Received:
8. 1. 2018

Accepted:
22. 1. 2018


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