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Biomedical subjects

R Asmar

Publications and source records attributed to R Asmar.

At least 19 recordsLinked to original sources
PubMed2006

Targeting effective blood pressure control with angiotensin receptor blockers.

Angiotensin receptor blockers (ARBs) have become established as a major class of antihypertensive on the basis of their powerful effects on blood pressure (BP), excellent tolerability and pleiotropic end-organ-protective effects. However, individual ARBs vary in antihypertensive efficacy, which may be important to clinical outcome. Several strategies are available to ensure that BP reductions with ARBs are at least as great as that which can be achieved with other antihypertensive classes. Firstly, several newer ARBs, including irbesartan, candesartan, telmisartan and olmesartan, have been reported to provide equivalent antihypertensive efficacy to amlodipine and greater efficacy than either losartan, valsartan or both. Secondly, increases in dose may improve the antihypertensive efficacy of agents such as valsartan, although clinical studies are necessary to provide characterisation of new, higher-dose monotherapies. Thirdly, fixed dose combinations with hydrochlorothiazide (HCTZ) increase the antihypertensive effect of all ARBs. It is likely that differences in efficacy between newer and older ARBs will in some cases be sustained in combination therapy, such that the most potent ARBs and HCTZ will provide another tier of control. The future use of ARBs is likely to involve a growing emphasis on compound-specific data, with regard to the antihypertensive efficacy and pleiotropic protective actions of agents.

Angiotensin Receptor Antagonists↗
PubMed2006

A placebo-controlled comparison of the efficacy and tolerability of candesartan cilexetil, 8 mg, and losartan, 50 mg, as monotherapy in patients with essential hypertension, using 36-h ambulatory blood pressure monitoring.

This double-blind, randomised, controlled study compared the efficacy of candesartan cilexetil 8 mg (n = 87) and losartan 50 mg (n = 89), once daily for 6 weeks, relative to placebo (n = 80) in patients with mild-to-moderate essential hypertension (diastolic blood pressure (DBP): 95-115 mmHg). Ambulatory BP measurements were done every 15 min over 36 h. At the end of the 6-week treatment, the mean change in DBP between the baseline and the 0-24-h period after the last dose of study medication was greater in patients receiving candesartan cilexetil 8 mg (-7.3 mmHg +/- 6.9 mmHg) compared with losartan 50 mg (-5.1 mmHg +/- 4.9 mmHg) (p < 0.05) or placebo (0.3 mmHg +/- 6.5 mmHg) (p < 0.001). The mean change in systolic BP (SBP) during this time was greater in patients receiving candesartan cilexetil 8 mg (-10.8 mmHg +/- 11.3 mmHg), or losartan 50 mg (-8.8 mmHg +/- 8.9 mmHg) than placebo (1.2 mmHg +/- 9.9 mmHg) (p < 0.001). Candesartan cilexetil 8 mg was associated with a greater reduction in DBP and SBP, relative to placebo, when compared with losartan 50 mg, during both daytime and night-time, and between 12 and 24 h after dosing (p < 0.001). Both active treatments were well tolerated. In patients with mild-to-moderate essential hypertension, candesartan cilexetil 8 mg therefore had greater, more consistent antihypertensive efficacy throughout the day and the night, and long-lasting efficacy after the last dose, compared with losartan 50 mg. This greater efficacy is maintained with an excellent tolerability associated with members of the angiotensin Il type 1-receptor blocker class.

Adolescent↗
PubMed2004

Switch from ABCD pretreatment to A-II-A treatment: a multinational, open, centrally randomized, prospective parallel group comparison.

The aim of this trial was to evaluate the efficacy and safety of switching antihypertensive monotherapy from a non-angiotensin II receptor blocker treatment, i.e., angiotensin-converting enzyme (ACE) inhibitor, beta-blocker, calcium (Ca2+) channel blocker or diuretic, to monotherapy with candesartan cilexetil 8 or 16 mg once daily. Patients (age 18-74 years) with mild to moderate essential hypertension were enrolled in this multinational, open-label, centrally randomized, prospective parallel group study. Previous antihypertensive treatment, with either an ACE inhibitor, a beta-blocker, a Ca2+ channel blocker or a diuretic, was maintained for a run-in period of 4 weeks and was then substituted at the baseline visit where patients were randomized into two groups to receive either candesartan cilexetil 8 mg (n = 985) or 16 mg (n = 982) once daily for an 8-week treatment period. Blood pressure (BP) reduction was the primary endpoint after 4 weeks of therapy and the secondary endpoint after 8 weeks of therapy. Results of the first 4 weeks of therapy are presented here. A total of 1,967 patients were included: 985 received candesartan cilexetil 8 mg and 982 candesartan cilexetil 16 mg once daily; 1,879 patients were included in the intention-to-treat analysis. The percentages of patients receiving an ACE inhibitor, a beta-blocker, a Ca2+ channel blocker or a diuretic as previous antihypertensive treatment were 44.7, 18.8, 30.6 and 5.9%, respectively. After 4 weeks of treatment with candesartan cilexetil 8 and 16 mg, sitting diastolic and systolic BP were reduced (mean +/- SD): -7 +/- 10 and -14 +/- 17 mmHg, and -8 +/- 10 and -16 +/- 16 mmHg, respectively. The percentage of patients who were still borderline hypertensive or hypertensive after 4 weeks of substitute treatment was lower in the candesartan cilexetil 16 mg group than in the 8 mg group: 7.1 and 5.3%, respectively, versus 9 and 7.4%, respectively. Reported adverse events were mild or moderate in intensity and in accordance with those reported in the literature. Candesartan cilexetil can be considered an effective and safe alternative to other common antihypertensive monotherapies in a large spectrum of patients with mild and moderate hypertension.

Antihypertensive Agents↗
PubMed2003

Effect of indapamide SR on microalbuminuria--the NESTOR study (Natrilix SR versus Enalapril Study in Type 2 diabetic hypertensives with micrOalbuminuRia)--rationale and protocol for the main trial.

In type 2 diabetic hypertensive patients, microalbuminuria can be due to hypertension and/or diabetic nephropathy. Angiotensin-converting enzyme (ACE) inhibitors act preferentially on microalbuminuria due to diabetic nephropathy. The objective is to demonstrate the efficacy of a thiazide-like diuretic, indapamide sustained release (SR), at reducing microalbuminuria in hypertensive type 2 diabetic patients in comparison with an ACE inhibitor, enalapril. The study is an international multicentre, 12-month, randomized, double-blind, controlled, two parallel group study of type 2 diabetic patients with hypertension (140 mmHg < or = systolic blood pressure <180 mmHg and diastolic blood pressure <110 mmHg) and microalbuminuria. Intervention is after a 4-week placebo period, patients with microalbuminuria > or = 20 and < or = 200 microg/min are randomized to indapamide SR 1.5 mg or to enalapril 10 mg once a day for a one-year treatment period. An additional label treatment by amlodipine 5-10 mg (1st step) and atenolol 50-100 mg (2nd step) a day is permitted after 6 weeks of treatment based upon blood pressure response. The main outcome measures are microalbuminuria expressed as urinary albumin to creatinine ratio, albumin fractional clearance, and albumin excretion rate evaluated on overnight urine collections. Secondary criteria are supine and standing systolic, diastolic and mean blood pressure; and biological and clinical safety. This study will complete the knowledge of the efficacy of indapamide SR in hypertension and target organ damage and will provide valuable information on the management of type 2 diabetic hypertensives with microalbuminuria.

Adult↗
PubMed2002

[Placebo effect on diastolic, systolic and pulsed arterial pressure].

UNLABELLED: THE PLACEBO EFFECT: In controlled clinical trials, use of a placebo has demonstrated that the lowering of blood pressure in hypertensive patients under medication is associated with a reduction in cardiovascular morbidity and mortality. Although a placebo clearly lowers levels of systolic and diastolic blood pressure (to varying degrees depending on the measurement used), it does not appear to have any effect on the pulse pressure, representing the difference between the systolic and diastolic pressures. CENTRAL MECHANISMS: The absence of placebo effect on the pulse pressure, demonstrated by controlled studies, suggests the activity of central mechanisms (notably bulbar), common to the placebo effect and to the control of neurogenic coupling between the heart and the large caliber arteries. IN PRACTICE: Since the pulse pressure after the age of 60 is a major factor for predicting myocardial infarction, these results suggest that modifications in pulse pressure should be more closely studied during controlled cardiovascular clinical trials in elderly patients.

Blood Pressure↗
PubMed2002

Efficacy of very low dose perindopril 2 mg/indapamide 0.625 mg combination on left ventricular hypertrophy in hypertensive patients: the P.I.C.X.E.L. study rationale and design.

The PICXEL study is designed to evaluate the effects of long-term administration of very low-dose combination perindopril 2 mg/indapamide 0.625 mg (Per/Ind) vs enalapril in reducing left ventricular hypertrophy (LVH) in hypertensive patients. This multicentre, controlled, randomised, double-blind, parallel group study is carried-out to assess the variation of left ventricular mass index (LVMI) after treatment, using a centralised control of M-mode echocardiography determinations, and a dedicated software for semi-automatic measurement. Following a 4-week placebo run-in period, hypertensive outpatients aged >/=18 years, with LVH (LVMI >120 and 100 g/m(2) for men and women, respectively), are randomised to receive once daily, over 52 weeks, either Per/Ind or enalapril. According to blood pressure levels, the dose may be adjusted. In addition to clinical examinations, ECG, blood pressure, heart rate and laboratory assessments echocardiographic determinations are performed for selection, at baseline, after 24 weeks and at the end of the study. The main outcome criteria is the change from baseline in LVMI which is considered the primary efficacy criterion; changes in blood pressure and echo-Doppler parameters constitute secondary criteria. Two-sided Student's t-test for independent samples will be used to differentiate the effects of the treatment between groups with alpha = 5%, and the inter-group difference of LVMI variation will be analysed with a power of 90%. A sample size of 500 patients is required making it necessary to randomise at least 550 patients, based on a 10% proportion of potentially non-assessable patients. The results of this study, obtained after applying strict methodological procedures and requirements, are expected to provide valuable and reliable information on the effects of long-term administration of Per/Ind on LVH, and on its potential superiority over enalapril.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2002

[Cardiovascular risk factors in France. Prevalence and association].

The object of this study was to assess the prevalence of modifiable cardiovascular risk factors and their association in 61,108 subjects over 15 years of age who volunteered for a systematic medical check-up, free of charge, and performed in a health centre in central France. The risk factors were defined as follows: hypertension, diabetes, hypercholesterolaemia, hypertriglyceridaemia: medical treatment or value above the upper limits of normal defined by national or international recommendations. obesity and android fat distribution as defined by the principal recommendations. The commonest risk factor was hypercholesterolaemia (60% of men and 64% of women) followed by android obesity. The prevalence of hypertension was greater in men than in women (44 vs 33%). Twenty eight per cent of men and 17% of women admitted to smoking. The percentage of smokers was higher in people under 30. Diabetes was observed in 3% of men and 2% of women. The association of risk factors was observed at an older age in women than in men. The association of 3 risk factors was four times greater in men than in women in the whole population. In conclusion, this study shows that cardiovascular risk factors are very common in persons undergoing a medical check-up and that these factors are often associated at an earlier age in men than in women.

Cardiovascular Diseases↗
PubMed2002

[Combination of low-dose perindopril/indapamide versus atenolol in the hypertensive patient. Effects on systolic pressure and arterial hemodynamics. REASON Study].

In hypertension, consideration of systolic blood pressure (SBP) and pulse pressure (PP) is now well recognized from epidemiological and therapeutical points of view, after numerous years of interest in only diastolic blood pressure. SBP, and also PP, are tightly linked to mechanical properties of large arteries. It is now possible to investigate precisely, with very good repeatability, these mechanic properties. The REASON study is an international multicenter randomised, controlled, parallel-groups study in essential hypertensives. The very low dose perindopril/indapamide combination (Per/Ind: 2 mg/0.625 mg) was compared with atenolol (50 mg) for a 12-month active treatment period in terms of blood pressure reduction efficiency and change in large artery hemodynamics to attempt to relate changes in pressure and changes in arterial mechanics. 471 patients suffering from hypertension were included, 406 benefitted from the treatment for one year (per-protocol analysis) and 96 benefitted from arterial investigations (pulse wave velocity and aortic wave reflection with applanation tonometry). Changes in brachial and central SBP and PP were higher with Per/ind than with atenolol. The reduction in pulse wave velocity was similar with both drugs, but aortic wave reflections were more reduced with Per/Ind than with atenolol. The very low dose perindopril/indapamide decreases SBP and PP to a larger extent than does a betablocker after a 12-month treatment. Changes in arterial mechanics, non invasively measured, were the same (pulse wave velocity) or in favour of Per/Ind vs atenolol (higher reduction in aortic wave reflection, with higher reductions in central systolic and pulse pressures).

Atenolol↗
PubMed2001

Pulse pressure and aortic pulse wave are markers of cardiovascular risk in hypertensive populations.

BACKGROUND: Pulse pressure (PP) and aortic pulse wave velocity (PWV) are significant markers of cardiovascular risk, but a similar role for central wave reflections has never been investigated. PROCEDURES: To determine the factors influencing PP, PWV, and carotid wave reflections, a cohort of 1087 patients with essential hypertension either treated or untreated was studied cross-sectionally. Atherosclerotic alterations (AA) were defined on the basis of clinical events and PWV evaluated from an automatic device. The carotid amplification index (CAI), a quantitative estimation of the magnitude of central wave reflections, was measured noninvasively from pulse wave analysis using radial and carotid aplanation tonometry. RESULTS: In the overall population, age and mean arterial pressure represented 30.4%, 32.3%, and 5.6% of the variance of, respectively PP, PWV, and CAI. For the latter, body weight and heart rate represented 22.9% of variability. On the basis of logistic regression, AA were associated, in addition to age, plasma creatinine and HDL cholesterol levels, and tobacco consumption to three mechanical factors, increased PP, increased PWV, and low diastolic blood pressure, but not by CAI (adjusted odds ratio: 1.00; 95% confidence intervals: 0.99-1.01). CONCLUSION: In cross-sectional hypertensive populations, PP and PWV, but not CAI, are significantly and independently associated with cardiovascular amplications.

Aged↗
PubMed2001

Evaluation of the placebo effect and reproducibility of blood pressure measurement in hypertension.

Pharmacologic studies in hypertension often describe blood pressure (BP) reductions in placebo control groups. This placebo effect is currently debated, as it seems to be related to BP measurement methods and as a regression to the mean phenomenon may lead to misinterpretation. Furthermore, data on pulse pressure are lacking. This study was designed to evaluate the placebo effect on BP and to differentiate it from regression to the mean. According to a crossover design, 26 mild-to-moderate hypertensive patients who were treated with placebo or given no treatment were followed-up for 1 month. Clinic and ambulatory BP was assessed at baseline and at the end of each 1-month period. Placebo administration resulted in significant reductions in clinic systolic, diastolic, and mean BP (P < .01), ambulatory 24-h SBP (P < .05), and daytime systolic, diastolic, and mean BP (P < .01, P < .05, P < .01, respectively). No significant differences were noted for pulse pressure and heart rate or between BP values measured at baseline and after 1 month without treatment. Despite a significant correlation between changes in clinic and ambulatory BP, the scatter of individual data suggests that the placebo response observed with one method cannot be systematically extrapolated to the other method. This study conclusively shows the effect of placebo in mild-to-moderate hypertension on both clinic and ambulatory systolic, diastolic, and mean BP, in which it has been shown to differ from the regression to the mean phenomenon. This effect was not observed for pulse pressure or heart rate.

Adult↗
PubMed2001

Reference values for clinic pulse pressure in a nonselected population.

A wide pulse pressure (PP) may constitute an independent predictor of cardiovascular morbidity and mortality. We assessed the reference values of brachial clinic PP, according to age and gender in a nonselected population (61,724 subjects) who were undergoing a routine systematic health examination. According to mean values, 50 mm Hg is likely the reference value for clinic PP in both men and women. Diagnostic thresholds for clinic PP (> or =65 mm Hg) determined either by adding 2 SD to the means or from the 95th percentiles are in close agreement with clinic PP values previously reported to be associated with increased cardiovascular morbidity and mortality.

Adolescent↗
PubMed2001

The effect duration of candesartan cilexetil once daily, in comparison with enalapril once daily, in patients with mild to moderate hypertension.

OBJECTIVE: To determine the antihypertensive efficacy, effect duration and safety of the angiotensin II type 1 receptor blocker candesartan cilexetil and the angiotensin converting enzyme inhibitor enalapril once daily in patients with mild to moderate hypertension. METHODS: A multicenter, randomised, double-blind parallel group study was performed in Finland, France, the Netherlands, Spain and Sweden. Three-hundred-and-ninety-five men and women in the age range 20-80 years with primary hypertension were randomised to an 8-week double-blind treatment period with either candesartan cilexetil 8-16 mg or enalapril 10-20 mg once daily, with forced dose titration after 4 weeks. Non-invasive ambulatory blood pressure was measured for 36 h at baseline and after 8 weeks. The primary efficacy variable was the change in mean diastolic and systolic ambulatory blood pressure 22-24 h post-dose. RESULTS: There was a significant difference in the adjusted mean difference for the change from baseline to week 8 between candesartan cilexetil and enalapril 22-24 h post-dose by -3.5 mmHg (95% confidence interval, CI: -6.8 to -0.3 mmHg; p < 0.032) in ambulatory systolic blood pressure and -3.0 mmHg (95% CI: -5.1 to -0.8 mmHg; p < 0.008) in ambulatory diastolic blood pressure. There was a significant difference in adjusted mean daytime ambulatory blood pressure 24-36 h post-dose by -4.2 mmHg (95% CI: -6.8 to -1.6 mmHg; p < 0.002)/-3.5 mmHg (95% CI: -5.1 to -1.8 mmHg; p < 0.001). Both drugs were generally well tolerated. CONCLUSION: The results of the present study suggest that advantages may be attributed to the use of candesartan cilexetil, as compared to enalapril in the treatment of patients with essential hypertension. In comparison with enalapril 20 mg, candesartan cilexetil 16 mg more effectively lowered blood pressure at trough and in particular on the day following the day after the last dose.

Adult↗
PubMed2001

Angiotensin II type 1 receptor-153A/G and 1166A/C gene polymorphisms and increase in aortic stiffness with age in hypertensive subjects.

OBJECTIVES: Arterial stiffness is associated with excess morbidity and mortality, independently of other cardiovascular risk factors. Age is the main determinant responsible for arterial wall changes leading to arterial stiffening. Environmental and genetic factors may however influence the magnitude of the effects of age on large artery stiffness. DESIGN AND METHODS: The present study assessed whether or not the relationship between age and aortic stiffness was influenced by genetic variants of angiotensinogen (AGT 174T/M, 235M/T), angiotensin converting enzyme (ACE I/D), angiotensin II type 1 receptor (AT1 1166A/C, -153A/G) and aldosterone synthase (CYP11B2 -344T/C). This study was realized in 441 untreated hypertensive subjects of European origin (aged 18-74 years). Aortic stiffness was assessed by carotid-femoral pulse wave velocity (PWV). RESULTS: Carriers of the angiotensin II type 1 receptor -153G allele showed a steeper age/PWV relationship than the AT1 -153AA subjects. The effect of the AT1 -153A/G polymorphism on aortic stiffness became apparent after the age of 55 years. In subjects with the AT1 1166C allele, the relationship age/PWV is shifted upward, indicating higher values of aortic stiffness at any age compared to the AT1 1166AA patients. Carriers of both the AT1 1166C and -153G alleles presented the additive effects of these 2 genotypes on aortic stiffness. Angiotensinogen, ACE and CYP11B2 genotypes did not influence the effects of age on PWV. CONCLUSIONS: AT1 receptor genotypes could influence arterial ageing in hypertensive subjects. These results also show that the association between genotypes and arterial stiffness may manifest itself later in life.

Adolescent↗
PubMed2001

Pulse wave velocity as endpoint in large-scale intervention trial. The Complior study. Scientific, Quality Control, Coordination and Investigation Committees of the Complior Study.

OBJECTIVE: To evaluate the ability of an antihypertensive therapy to improve arterial stiffness as assessed by aortic pulse wave velocity (PWV) in a large population of hypertensive patients. SETTING: Sixty-nine healthcare centres, private and institutional (19 countries). PATIENTS: Subjects aged 18-79 years, with essential hypertension. A total of 2,187 patients were enrolled; 1,703 (52% male) completed the study: mean age = 50 +/- 12 years; mean baseline systolic/diastolic blood pressure (S/D BP) = 158 +/- 15/98 +/- 7 mmHg; mean baseline carotid-femoral PWV = 11.6 +/- 2.4 m/s. INTERVENTIONS: Patients were treated for 6 months, starting with perindopril (angiotensin converting enzyme (ACE) inhibitor) 4 mg once daily (OD), increased to 8 mg OD, and combined to diuretic (indapamide 2.5 mg OD) if BP was uncontrolled (> 140/90 mmHg). RESULTS: It was feasible to measure carotid-femoral PWV using the automatic device Complior at inclusion, 2 and 6 months, along with conventional BP assessments in a population of 1,703 patients. Significant decreases (P < 0.001) in BP (systolic: -23.7 +/- 16.8, diastolic: -14.6 +/- 10 mmHg), and carotid-femoral PWV (-1.1 +/- 1.4 m/s) were obtained at 2 and 6 months. CONCLUSIONS: The Complior Study is the first study to show the feasibility of a large-scale intervention trial using PWV as the endpoint in hypertensive patients. Adequate results may be obtained using an automatic device and rigorous criteria for assessment. A long-term controlled intervention study is needed to confirm the results of the present uncontrolled trial.

Adult↗
PubMed2001

High blood pressure and associated cardiovascular risk factors in France.

OBJECTIVE: To estimate, with respect to age and gender, the prevalence of high blood pressure (BP) in treated and non-treated subjects and its association with other cardiovascular risk factors. DESIGN: A cross-sectional study. SETTING: Healthcare centres in the centre of France. PARTICIPANTS: All subjects (n = 61,108) who had a free health check-up, between February 1995 and September 1996. MAIN OUTCOME MEASURES: High BP (systolic blood pressure (SBP) > 140 mmHg, diastolic blood pressure (DBP) > 90 mmHg or antihypertensive therapy); diabetes (fasting glucose plasma concentration > 1.26 g/l or antidiabetic therapy); hypercholesterolaemia (total cholesterol > 2 g/l or lipid-lowering therapy); hypertriglyceridaemia (fasting triglycerides plasma concentration > 2 g/l or triglyceridaemia-lowering therapy); overweight (body mass index >or= 25 kg/m2); abdominal fat distribution (waist to hip ratio > 0.9 in males and > 0.8 in females). RESULTS: Prevalence of high BP was 37.7% in males and 22.2% in females. BP was normalized in 29.7% of treated males and 44.1% of treated females. High BP was associated with at least another cardiovascular risk factor in 83.8% of the males and 76.7% of the females with high BP. Hypercholesterolaemia was the most frequently associated risk factor. Except smoking, the prevalence of each cardiovascular risk factor was shown to increase with the severity of hypertension. Two or more other cardiovascular risk factors were present in 22.9% of the males and 9.8% of the females with high BP. CONCLUSIONS: Rate of high BP, even in treated subjects, is high. More than three out of four subjects with high BP have at least one other cardiovascular risk factor.

Adolescent↗
PubMed2001

Assessment of outcomes other than systolic and diastolic blood pressure: pulse pressure, arterial stiffness and heart rate.

In recent years, studies have shown that parameters derived from the arterial pressure wave other than systolic and diastolic blood pressure provide important information on cardiovascular status. Among these parameters, pulse pressure, arterial stiffness and heart rate have emerged as independent markers of cardiovascular risk in different populations. Although a number of studies have used casual measurements of these parameters in a clinic setting, others have focused on their assessment under ambulatory conditions. The pulse pressure represents the amplitude of the pressure wave signal (systolic minus diastolic blood pressure), higher pulse pressure values having been reported in patients possessing cardiovascular risk factors. Close associations between a high pulse pressure and several surrogate end-points have been described. Furthermore, epidemiological studies have shown that a high pulse pressure is an independent predictor of hard end-points in several populations. Arterial stiffness represents one of the major haemodynamic factors determining pulse pressure. Pulse wave velocity, measured from the initial upstroke of the pressure wave, constitutes an established index of arterial stiffness. Studies have reported stiffer arteries in patients with cardiovascular pathology even at an early stage of disease. Close correlations between arterial stiffness and several surrogate markers have been reported, and arterial stiffness and its changes have recently been shown to be an independent predictor of hard end-points in patients with a high cardiovascular risk. Methods to evaluate arterial stiffness under ambulatory conditions are emerging. Heart rate represents the frequency of the cyclical strain of the arterial wall, clinical studies having shown that ambulatory heart rate is correlated to several surrogate markers. A few epidemiological studies have analysed the value of ambulatory heart rate as an independent predictor of hard end-points, but their positive findings need to be confirmed. The analysis of the pressure wave thus allows the determination of several haemodynamic indices other than systolic and diastolic blood pressure. Pulse pressure, arterial stiffness and heart rate constitute other outcomes that may be useful as additional factors in risk assessment for future therapeutic decision-making.

Arteries↗