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Arterial (aortic) stiffness in patients with resistant hypertension: from assessment to treatment

Citation

Sharman, JE and Boutouyrie, P and Laurent, S, Arterial (aortic) stiffness in patients with resistant hypertension: from assessment to treatment, Current Hypertension Reports, 19, (1) Article 2. ISSN 1522-6417 (2017) [Refereed Article]

Copyright Statement

Copyright 2017 Springer Science+Business Media New York

DOI: doi:10.1007/s11906-017-0704-7

Abstract

Purpose of Review: The purpose of the review is to examine whether measurement of aortic stiffness could be especially value-adding for risk stratification and treatment among patients with resistant hypertension (RH).

Recent Findings: Adverse arterial remodeling and increased aortic stiffness is associated with RH, and it may be of additional clinical benefit to measure aortic stiffness in these patients. However, there is insufficient evidence to determine whether aortic stiffness is excessively high relative to the level of blood pressure (BP) among people with RH. This issue needs resolution as it could help refine management decisions guided by aortic stiffness. If conventional antihypertensive therapy fails to lower BP in patients with RH, there is good rationale for effectiveness of spironolactone as add on therapy, and this should also improve aortic stiffness. Lifestyle intervention with exercise and diet should be additionally efficacious towards improving BP and aortic stiffness in patients with RH, but there is limited data in this patient population. For better characterization on the effects of BP treatment on aortic stiffness, measures of central aortic BP may help refine management decisions above and beyond conventional arm cuff BP.

Summary: There is strong evidence to support the use of aortic stiffness as a tool to aid risk stratification in hypertension management. Although there is a theoretical basis for special additional benefit of measuring aortic stiffness in patients with RH (as distinct from uncomplicated hypertension), at this time, there is inadequate data available to make definitive conclusions and is an area for future investigation.

Item Details

Item Type:Refereed Article
Keywords:blood vessels, cardiovascular systems, drug therapies, hemodynamic, pharmacotherapies
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:115385
Year Published:2017
Web of Science® Times Cited:18
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-03-21
Last Modified:2022-08-25
Downloads:0

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