Vascular compliance in blood pressure

Leopoldo Raij, Alba M. Gonzalez-Ochoa

Research output: Contribution to journalReview article

19 Scopus citations

Abstract

Purpose of Review: Vascular stiffening is a hallmark of the aging process. Improvements in the methods used to measure central stiffness, particularly applanation tonometry, and their use as therapeutic targets have generated great interest. Recent Findings: Vascular stiffness is associated with increases in pulse pressure (PP), aortic augmentation index, and pulse wave velocity (PWV). This last has emerged as the gold standard for evaluation of vascular stiffness, as it is an independent predictor of coronary heart disease, stroke, and mortality. Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and calcium-channel blockers with or without diuretics are all commonly used to ameliorate vascular stiffness; however, selective β-1 blockers (β-blockers) may actually worsen aortic PP and aortic augmentation index. Summary: Serial measurements of vascular stiffness, including PWV, augmentation index, and PP, may be especially beneficial in older patients to supplement brachial blood pressure. At present, given the lack of universally accepted normal values for vascular stiffness as measured by applanation tonometry, serial measurements over time may be more helpful than a single isolated value. In patients with suspected vascular stiffening, therapy should include inhibition of the renin-angiotensin-aldosterone system with ACE inhibitors or ARBs, calcium-channel blockers, and diuretics as needed to normalize blood pressure. β-Blockers should be reserved for patients with a history of myocardial infarction or congestive heart disease. It remains to be established whether β-blockers with vasodilator properties could improve the assessment of vascular compliance.

Original languageEnglish (US)
Pages (from-to)457-464
Number of pages8
JournalCurrent Opinion in Nephrology and Hypertension
Volume20
Issue number5
DOIs
StatePublished - Sep 1 2011

Keywords

  • aortic pressure wave
  • arterial stiffness
  • pulse pressure
  • pulse wave velocity
  • wave reflection

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine

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