Pulse pressure--a review of mechanisms and clinical relevance.
By A. Dart, B. Kingwell. Journal of the American College of Cardiology, 2001
832 citations recorded by the source corpus.
The goal of this study was to review the origin, clinical relevance and treatment of pulse pressure (PP). Elevated PP is increasingly being recognized as a risk factor for cardiovascular, particularly coronary, disease. Pulse pressure is discussed in terms of both Windkessel and distributive models of the arterial circulation. Pulse pressure arises from the interaction of cardiac ejection (stroke volume) and the properties of the arterial circulation. An increased stiffness of the aorta and large arteries leads to an increase in PP through a reduction in arterial compliance and effects on wave reflection. A number of factors are known to influence arterial wall behavior and, therefore, PP. In addition to the effects of aging and blood pressure on arterial wall elasticity, there is some evidence that atherosclerosis, per se, amplifies these effects. Thus, the relationship between PP and coronary disease may be bidirectional. A number of dietary and lifestyle interventions have been shown to modify large artery behavior. These include aerobic exercise training and consumption of n-3 fatty acids. Conversely, strength training is associated with an increase in arterial stiffness and a higher PP. The effects of antihypertensive medication have been extensively studied, but many studies are difficult to interpret because of concomitant change in blood pressure, and to a lesser degree, heart rate. However a number of studies do suggest direct arterial wall effects, particularly for angiotensin-converting enzyme inhibitors. A distributed compliance model of the arterial circulation provides a framework for understanding the causes, effects and potential treatment of elevations in PP.
Subfields: Cardiology and Cardiovascular Medicine
View Paper: https://www.semanticscholar.org/paper/ca98fc8aee2113dab83fdbdf80ee172e17b30372
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In Cardiology and Cardiovascular Medicine
Citations in the corpus
- Arterial Stiffness, Wave Reflections, and the Risk of Coronary Artery Disease (2004, methodology): “The extent of CAD was defined as (1) 1-, 2-, or 3-vessel disease and (2) addition of a modified stenosis score system (minimum score was 0; maximum score was 27),15 with 0, 1, 2, and 3 points, respectively, for 50%, 50% to 70%, 71% to 89%, and 90% diameter stenosis in 1 to 3 segments of the 3 main c”
- Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness (2018, background): “Smooth muscle is essential for the optimal function of blood vessels, primarily maintaining blood pressure through contraction and relaxation in opposition to the heart.(19) VSMCs also play a vital role in maintaining and remodelling the extracellular matrix (ECM) of blood vessels.”