Effects of arterial stiffness, pulse wave velocity, and wave reflections on the central aortic pressure waveform.


Journal Article (Review)

Brachial systolic and pulse blood pressures (BPs) are better predictors of adverse cardiovascular (CV) events than diastolic BP in individuals older than 50 years. The principal cause of increased systolic and pulse BP is increased stiffness of the elastic arteries as a result of degeneration and hyperplasia of the arterial wall. Recent studies have shown that central BP, the pressure exerted on the heart, brain, and kidneys, is a better predictor of CV risk than brachial BP. As stiffness increases, reflected wave amplitude increases and augments pressure in late systole, producing an increase in left ventricular afterload and myocardial oxygen demand. Vasoactive drugs have little direct effect on large human elastic arteries but can markedly modify wave reflection by altering stiffness of the muscular arteries and changing pulse wave velocity of the reflected wave from the periphery to the heart. Vasodilators decrease the amplitude and increase the travel time (or delay) of the reflected wave, causing a generalized decrease in systolic BP. The decrease in systolic BP brought about by this mechanism is grossly underestimated when systolic BP is measured in the brachial artery.

Full Text

Cited Authors

  • Nichols, WW; Denardo, SJ; Wilkinson, IB; McEniery, CM; Cockcroft, J; O'Rourke, MF

Published Date

  • April 2008

Published In

Volume / Issue

  • 10 / 4

Start / End Page

  • 295 - 303

PubMed ID

  • 18401227

Pubmed Central ID

  • 18401227

Electronic International Standard Serial Number (EISSN)

  • 1751-7176

International Standard Serial Number (ISSN)

  • 1524-6175

Digital Object Identifier (DOI)

  • 10.1111/j.1751-7176.2008.04746.x


  • eng