What is the clinical evidence from this study?

Study design: Review. Population: Arterial stiffness. Intervention: Vasodilators.

What question did this study set out to answer?

Examine how arterial stiffening, pulse wave velocity, and wave reflections alter central aortic pressure waveforms and impact cardiovascular risk assessment.

April 1, 2008Journal of Clinical HypertensionOpen Access

Effects of Arterial Stiffness, Pulse Wave Velocity, and Wave Reflections on the Central Aortic Pressure Waveform

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Key result

Vasodilators decrease the amplitude and increase the travel time of the reflected wave, causing a decrease in systolic BP that is grossly underestimated when measured in the brachial artery.

Design

Review

Authors

WNWilmer W. NicholsVascular / Pulmonary Vascular SDScott J. DenardoDuke University IWIan B. WilkinsonSemmelweis University

Discussion

Member takes

Implication

Brachial measurements may underestimate vasodilator effects on central systolic pressure; leaves open whether central BP monitoring should guide therapy.

Key Points

Examine how arterial stiffening, pulse wave velocity, and wave reflections alter central aortic pressure waveforms and impact cardiovascular risk assessment.
Synthesized physiological and clinical evidence examining central versus brachial blood pressure dynamics in predicting cardiovascular risk.
Evaluated the mechanical impacts of arterial wall remodeling, pulse wave velocity, and vasoactive drugs on reflected pressure waves.
Arterial stiffening increases reflected wave amplitude to augment late systolic pressure, substantially raising left ventricular afterload and myocardial oxygen demand.
Central aortic blood pressure directly strains vital organs and predicts cardiovascular risk more accurately than brachial blood pressure.
Vasodilators delay and attenuate reflected waves to lower central systolic pressure, a therapeutic benefit grossly underestimated by standard arm cuff measurements.

PICO

Population

Arterial stiffness

Exposure / Comparator

Vasodilators

Central aortic pressure is a better predictor of cardiovascular risk than brachial pressure, and the effects of vasodilators on systolic BP are underestimated by brachial measurements.

Cite This Study

Nichols et al. (2008) conducted a review in Arterial stiffness. Vasodilators was evaluated. Vasodilators decrease the amplitude and increase the travel time of the reflected wave, causing a decrease in systolic BP that is grossly underestimated when measured in the brachial artery.

synapsesocial.com/papers/6a7dc4217c193befc4339efd https://doi.org/10.1111/j.1751-7176.2008.04746.x

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Implication

Brachial measurements may underestimate vasodilator effects on central systolic pressure; leaves open whether central BP monitoring should guide therapy.

Effects of Arterial Stiffness, Pulse Wave Velocity, and Wave Reflections on the Central Aortic Pressure Waveform

Discussion

Member takes

Implication

Key Points

PICO

Cite This Study

Effects of Arterial Stiffness, Pulse Wave Velocity, and Wave Reflections on the Central Aortic Pressure Waveform

Discussion

Member takes

Implication

Key Points

PICO

Cite This Study

Also Consider

Also Consider