Pulse pressure,heart rate,and drug treatment of hypertension |
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Authors: | Michel E Safar |
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Institution: | 1.Centre de diagnostic,H?pital H?tel-Dieu,Paris Cedex 04,France |
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Abstract: | Peak-systolic blood pressure (SBP) and end-diastolic blood pressure (DBP) have been considered the exclusive mechanical factors
predicting cardiovascular (CV) risk in populations of normotensive and hypertensive subjects. The purpose of this review is
to show that in addition to SBP and DBP, other hemodynamic indices that have particular relevance for coronary complications
and originate from pulse pressure (PP) should be taken into account, namely brachial PP and, potentially, heart rate (HR).
In normotensive and hypertensive populations, increased PP is an independent predictor for myocardial infarction, more powerful
than SBP, even in hypertensive subjects under successful antihypertensive drug therapy. Increased HR is an additional CV risk
factor, acting particularly through the presence of an enhanced PP x HR product. Such findings, observed during a period in
which standard antihypertensive agents are known to reduce SBP and PP to a much lesser extent than DBP, require the development
of intervention trials using drugs acting specifically on SBP, PP, and arterial stiffness. |
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Keywords: | |
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