Role of Central Arterial Blood Pressure in Cardiovascular risk Assessment

Author: Vladimir Vasilev, Joanna Matrozova, Sabina Zacharieva

Abstract:

Blood pressure measurement constitutes one of the essential sources of information in the clinical assessment of health. For over 100 years the auscultatory method for its determination in the brachial artery has been the major basis of almost all investigations in the field of arterial hypertension. Due to wave reflection at the peripheral arterioles, however, the blood pressure in the upper limb does not represent the central blood pressure. Central pressure is the pressure that target organs encounter and the calculation of its values in the ascending aorta and the carotid artery are expected to be more useful than brachial pressure for estimating cardiovascular risk in patients with hypertension. Several techniques for non-invasive determination of central blood pressure have been designed, that use analysis of the pulse waveform recorded at the radial artery. An increasing body of evidence supports the superiority of central over peripheral blood pressure values for predicting cardiovascular events. Some antihypertensive drugs have a greater effect on central pressure and therefore its determination would be useful for monitoring of the therapeutic responses in patients with arterial hypertension.