Impact of aortic rather than brachial pulsatile haemodynamics on variations in end-organ measures across the full adult blood pressure range

Abstract

Beyond brachial BP, pulsatile haemodynamics rather than steady-state pressures account for end-organ effects more consistently across the normotensive than the hypertensive BP range. Hence, targeting aortic pulsatile haemodynamic changes may best limit BP-related cardiovascular risk within the normotensive BP range.

May Measurement Month 2018: an analysis of blood pressure screening results in South Africa

“…Although, one-third of participants had hypertension, this proportion is marginally lower than the prevalence of hypertension (women: 43%; men: 51%) previously reported for those aged 35–44 years in 2016, 4 and in a cohort with a similar mean age (43 years) from a community-based study (40.4%). 9 That only half of hypertensives were receiving treatment for hypertension also confirms previous reports from a community-based study (52.7%), 10 in rural and urban research sites (21.6–55.8%), 11 and in a cohort study of hypertensive nurse practitioners (59%). 12 Similarly, the low proportion with controlled BP is in keeping with low proportions with controlled BP on medication (women: 6.7%; men: 2.5%) previously reported for those aged 35–44 years in South Africa in 2016, 4 and in data from a community-based study, 10 a cohort study 12 and in rural and urban research sites 11 where 77.4%, 61.9%, and 67.7–92.2% of hypertensives had uncontrolled BP, respectively.…”

“… 9 That only half of hypertensives were receiving treatment for hypertension also confirms previous reports from a community-based study (52.7%), 10 in rural and urban research sites (21.6–55.8%), 11 and in a cohort study of hypertensive nurse practitioners (59%). 12 Similarly, the low proportion with controlled BP is in keeping with low proportions with controlled BP on medication (women: 6.7%; men: 2.5%) previously reported for those aged 35–44 years in South Africa in 2016, 4 and in data from a community-based study, 10 a cohort study 12 and in rural and urban research sites 11 where 77.4%, 61.9%, and 67.7–92.2% of hypertensives had uncontrolled BP, respectively. The proportions of South Africans with hypertension, aware that they have hypertension, receiving antihypertensive treatment and having uncontrolled BP are comparable with the worldwide data reported for screening in 2018.…”

Viewpoint: The Case for Non-Invasive Central Aortic Pressure Monitoring in the Management of Hypertension

“…Central aortic systolic blood pressure (cSBP) fits within the current paradigm for utilizing peripheral (brachial) systolic blood pressure (pSBP) in that management decisions are currently guided by predefined pSBP thresholds as well as diastolic BP thresholds in all national and international hypertension guidelines. However, given the significant difference between cSBP and pSBP and the high variability of cSBP within hypertension pSBP class [10], measuring cSBP can differentiate patients with risk even if they have the same pSBP [17,18].…”