Statins, Central Blood Pressure, and Blood Pressure Amplification

摘要: It is well established that blood pressure (BP) differs markedly between peripheral (brachial) and central arteries (aorta).1 As the wave travels distally from heart, mean BP diastolic decrease slightly (1 to 2 mmHg), but a gradual significant increase of systolic (SBP) pulse (PP) occurs. This phenomenon called amplification.1 The development commercially available devices for assessment has boosted this field clinical research.1–3 Numerous studies have shown close pathophysiological connection cardiovascular diseases1–4 highlighted ability provide complementary data on risk beyond provided by brachial BP.2–6 Article p 53 In present issue Circulation,7 Conduit Artery Function Evaluation-Lipid-Lowering Arm (CAFE-LLA, substudy Anglo-Scandinavian Cardiac Outcomes Trial [ASCOT]l8,9) effect statins presented. Before commenting data, we briefly summarize pathophysiology PP amplification. Finally, discuss potential strategies based hemodynamics will hopefully improve reduction. As consequence pulsatile nature flow presence arterial stiffness/diameter gradient along tree, reflections arise at various sites bed.1 backward-traveling reflected sums up with forward-traveling wave, forming actual waveform (Figure 1a). Whereas in healthy young subjects average aortic SBP 100 110 mm Hg, same time amplified substantially reaches 120 130 Hg.10 difference 10 30 Hg expresses amplification 1a).1,10 Because DBP practically steady aorta …