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Titolo:
Can arterial stiffness be reversed? And if so, what are the benefits?
Autore:
Safar, ME;
Titolo Testata:
AMERICAN JOURNAL OF MANAGED CARE
fascicolo: 12, volume: 5, anno: 1999, supplemento:, S
pagine: S718 - S727
SICI:
1088-0224(199908)5:12<S718:CASBRA>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONVERTING-ENZYME-INHIBITION; CAROTID-ARTERY; ANTIHYPERTENSIVE TREATMENT; CARDIOVASCULAR MORTALITY; MYOCARDIAL-INFARCTION; MECHANICAL-PROPERTIES; HYPERTENSIVE PATIENTS; CARDIAC-HYPERTROPHY; PULSE PRESSURE; BLOOD-PRESSURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
M.E. Safar, "Can arterial stiffness be reversed? And if so, what are the benefits?", AM J M CARE, 5(12), 1999, pp. S718-S727

Abstract

Systolic and diastolic blood pressure are generally considered to be the exclusive mechanical factors 'that predict cardiovascular risk in normotensive and hypertensive populations. However, these 2 measures give an incomplete picture when evaluating risk for cardiovascular events. Rather, one mustconsider the entire blood pressure curve when assessing risk. The blood pressure curve has 2 components: the mean arterial pressure and the pulse pressure. Both components of the blood pressure curve also vary which age. Abnormalities of the large arteries predominate over abnormalities of the small arteries in the elderly, causing a predominant increase in pulse pressure. This pattern is also observed in persons with diabetes and in those with end-stage renal disease. As a result of these changes, the shapes of the blood pressure curves fromolder patients and younger ones are very different, despite the same mean,arterial pressure. Mean arterial pressure has recently been shown to be a predictor of risk for events involving the cerebral vessels, the coronary vessels, and the kidney. Pulse pressure has an additional effect on cardiovascular mortality: it is an independent predictor of cardiac death and, to alesser extent, stroke death, particularly in women over the age of 55. It is possible to reverse pulsatile arterial hemodynamics in patients withhypertension, particularly with the use of angiotensin-converting enzyme (ACG) inhibitors. Several techniques are available to measure arterial stiffness, for which pulse pressure is a surrogate. ACE inhibition with perindopril has been shown to increase the diameter ofmuscular arteries in patients with hypertension, demonstrating a drug-induced effect on the arterial wall. Furthermore, there was an additional improvement in brachial artery compliance at the end of 12 months with perindopril treatment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/03/20 alle ore 10:58:11