This Article Full Text Full Text (PDF) All Versions of this Article: 54/5/958    most recent HYPERTENSIONAHA.109.137638v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Cameron, J. D. PubMed PubMed Citation Articles by Cameron, J. D. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Clinical Studies Related Article

(Hypertension. 2009;54:958.)
© 2009 American Heart Association, Inc.

Editorial Commentaries

Wave Intensity Analysis and Central Blood Pressure

James D. Cameron

From the Monash Cardiovascular Research Centre, MonashHEART, Monash Medical Centre and La Trobe University, Melbourne, Australia.

Correspondence to Professor James D. Cameron, Director, Monash Cardiovascular Research Centre, Monash Medical Centre, 246 Clayton Road, Clayton 3168, Melbourne, Australia. E-mail james.cameron@med.monash.edu.au

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In this issue of Hypertension, Manisty and colleagues¹ provide, using wave intensity analysis (WIA), new insight into hemodynamic mechanisms of blood flow and energy transfer in conduit arteries which are relevant to the basic pathophysiology of cardiovascular disease. WIA provides a further computational approach to assessing central arterial function and determinants of central blood pressure (the authors provide a summary of the principles involved in WIA as an online supplement to their article).

The reported results are pertinent to 3 important, obviously interrelated, but as yet very incompletely understood issues:

1. A growing, but currently unproven, perception that there may be differences between antihypertensive drug types, or even intragroup differences, in their affect on cardiovascular outcome over and above equivalent effects on clinic (brachial) blood pressure.
   
2. The likely but again unproven association of central blood pressure independent of peripheral (brachial) blood pressure with adverse cardiovascular outcome;
   
3. An improved understanding of the underlying mechanisms determining central blood pressure waveform, important in view of point 2 above and because of the popular application of techniques of pulse wave analysis (PWA).
   

There is reasonable evidence supporting the contention that brachial, and more particularly central, blood pressure indices can usefully be considered as biomarkers of cardiovascular disease (ie, of underlying arterial dysfunction) rather than as being a primary determinant of disease in their own right. This highlights growing awareness that there is more to assessment of vascular health than measurement of brachial blood pressure and traditional clinical assessment. The notion underlies interest in local . . . [Full Text of this Article]

Related Article:

Atorvastatin Treatment Is Associated With Less Augmentation of the Carotid Pressure Waveform in Hypertension: A Substudy of the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT)

Charlotte Manisty, Jamil Mayet, Robyn J. Tapp, Peter S. Sever, Neil Poulter, Simon A. McG. Thom, Alun D. Hughes on behalf of the ASCOT Investigators
Hypertension 2009 54: 1009-1013. [Abstract] [Full Text] [PDF]