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 2017 Springer Science+Business Media New York
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 Type:||Refereed Article|
|Keywords:||blood vessels, cardiovascular systems, drug therapies, hemodynamic, pharmacotherapies|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|UTAS Author:||Sharman, JE (Professor James Sharman)|
|Web of Science® Times Cited:||9|
|Deposited By:||Menzies Institute for Medical Research|
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