Clinical significance of central blood pressure measurement in antihypertensive treatment.

EVALUATION OF

Miyashita H, Aizawa A, Hashimoto J et al. Cross-sectional characterization of all classes of antihypertensives in terms of central blood pressure in Japanese hypertensive patients. Am. J. Hypertens. 23(3), 260-268 (2010). Central blood pressure (CBP) more directly imposes mechanical stress on the left ventricle, large arteries and the vital organ vasculature than peripheral blood pressure. Although CBP is most accurately measured using invasive devices, several methods have been developed recently to derive CBP by noninvasive techniques. Several studies have demonstrated that CBP is superior to peripheral blood pressure as a cardiovascular predictor in hypertensive patients, but the clinical significance of CBP measurement has not been fully examined. The paper under evaluation offers cross-sectional observational results assessing all classes of antihypertensive drugs in relation to CBP measured by a noninvasive technique. This study demonstrates that vasodilatory antihypertensives lower CBP independently of peripheral blood pressure levels without evident class-specific differences, whereas nonvasodilators may raise CBP. Thus, this study establishes the clinical significance of CBP measurement by demonstrating differences in the effects of various antihypertensive drugs on CBP and peripheral blood pressure, the more common clinical measure.