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Effect of angiotensin II blockade on central blood pressure and arterial stiffness in subjects with hypertension.

Safar ME - Int J Nephrol Renovasc Dis (2010)

Bottom Line: The angiotensin-converting enzyme (ACE) inhibitor perindopril not only reduces mean arterial pressure but also acts specifically on pulse pressure.In hypertensive subjects, perindopril and other ACE inhibitors seem to predict more consistently the reduction of cardiovascular events, mainly of cardiac origin, than standard β-blockers alone.This effect is associated with the important biochemical finding that mechanotransductions of angiotensin and β-blockade are markedly different, acting in the former specifically on the α5β1 integrin complex and on the fibronectin ligand of arterial vessels.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu Centre de Diagnostic et de Thérapeutique, Paris, France. michel.safar@htd.aphp.fr

No MeSH data available.


Related in: MedlinePlus

The augmentation index is the ratio of the difference between peak systolic blood pressure, shoulder of the ascending part of the blood pressure curve, and pulse pressure.1–4 The augmentation index, measured as a percentage, represents the supplementary increase in systolic blood pressure due to wave reflections. This hemodynamic profile is observed in the elderly but not in young people (see also Figure 3).
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f2-ijnrd-3-167: The augmentation index is the ratio of the difference between peak systolic blood pressure, shoulder of the ascending part of the blood pressure curve, and pulse pressure.1–4 The augmentation index, measured as a percentage, represents the supplementary increase in systolic blood pressure due to wave reflections. This hemodynamic profile is observed in the elderly but not in young people (see also Figure 3).

Mentions: Large artery elasticity or stiffness is usually determined from systolic and diastolic changes in artery diameter, coupled with measurement of local pulse pressure, which is the difference between systolic BP and diastolic BP.1–4 However, the most common method for evaluating arterial stiffness is based on the study of pulse wave velocity, ie, the velocity of the BP propagation wave along a given conduit artery, eg, the aorta. Pulse wave velocity can be determined from measurements of pulse transit time and the distance travelled by the pulse between the common carotid and femoral arteries. Aortic pulse wave velocity (carotid to femoral) can be measured by applanation tonometry, mechanotransducer, or Doppler probes and is regarded as the gold standard for determining arterial stiffness, independent of wave activity. The technique of applanation tonometry is widely used to evaluate central BP and also wave reflections through the determination of the augmentation index, a noninvasive parameter (Figure 2). The augmentation index is a measure of the contribution that wave reflection makes to the central pressure wave. It is defined as the difference between the second and first peaks (P2-P1) corresponding to systolic BP and is expressed as a percentage of the pulse pressure. Therefore, the augmentation index is a quite indirect measure of systemic stiffness and is mostly a direct measure of wave reflection, a parameter defined later in this review.


Effect of angiotensin II blockade on central blood pressure and arterial stiffness in subjects with hypertension.

Safar ME - Int J Nephrol Renovasc Dis (2010)

The augmentation index is the ratio of the difference between peak systolic blood pressure, shoulder of the ascending part of the blood pressure curve, and pulse pressure.1–4 The augmentation index, measured as a percentage, represents the supplementary increase in systolic blood pressure due to wave reflections. This hemodynamic profile is observed in the elderly but not in young people (see also Figure 3).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108785&req=5

f2-ijnrd-3-167: The augmentation index is the ratio of the difference between peak systolic blood pressure, shoulder of the ascending part of the blood pressure curve, and pulse pressure.1–4 The augmentation index, measured as a percentage, represents the supplementary increase in systolic blood pressure due to wave reflections. This hemodynamic profile is observed in the elderly but not in young people (see also Figure 3).
Mentions: Large artery elasticity or stiffness is usually determined from systolic and diastolic changes in artery diameter, coupled with measurement of local pulse pressure, which is the difference between systolic BP and diastolic BP.1–4 However, the most common method for evaluating arterial stiffness is based on the study of pulse wave velocity, ie, the velocity of the BP propagation wave along a given conduit artery, eg, the aorta. Pulse wave velocity can be determined from measurements of pulse transit time and the distance travelled by the pulse between the common carotid and femoral arteries. Aortic pulse wave velocity (carotid to femoral) can be measured by applanation tonometry, mechanotransducer, or Doppler probes and is regarded as the gold standard for determining arterial stiffness, independent of wave activity. The technique of applanation tonometry is widely used to evaluate central BP and also wave reflections through the determination of the augmentation index, a noninvasive parameter (Figure 2). The augmentation index is a measure of the contribution that wave reflection makes to the central pressure wave. It is defined as the difference between the second and first peaks (P2-P1) corresponding to systolic BP and is expressed as a percentage of the pulse pressure. Therefore, the augmentation index is a quite indirect measure of systemic stiffness and is mostly a direct measure of wave reflection, a parameter defined later in this review.

Bottom Line: The angiotensin-converting enzyme (ACE) inhibitor perindopril not only reduces mean arterial pressure but also acts specifically on pulse pressure.In hypertensive subjects, perindopril and other ACE inhibitors seem to predict more consistently the reduction of cardiovascular events, mainly of cardiac origin, than standard β-blockers alone.This effect is associated with the important biochemical finding that mechanotransductions of angiotensin and β-blockade are markedly different, acting in the former specifically on the α5β1 integrin complex and on the fibronectin ligand of arterial vessels.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu Centre de Diagnostic et de Thérapeutique, Paris, France. michel.safar@htd.aphp.fr

No MeSH data available.


Related in: MedlinePlus