Central pressure in clinical practice: current state of the problem
Pathophysiologic mechanisms of central aortal pressure (CAP) are more complex than those of peripheral pressure, measured at brachial artery level. CAP indirectly reflects the state of circulatory system as a whole, since it is modulated by aorta elasticity, as well as structure and function of middle arteries and microcirculatory vessels. The difference between central and peripheral systolic blood pressure is maximal in young people and decreases in the elderly. For non-invasive CAP measurement, radial artery applanation tonometry is used, with subsequent computer transformation of peripheral pulse wave into central one, or applanation tonometry of carotid artery. The growing body of evidence supports the use of CAP measurement in assessing cardiovascular risk assessment and comparing various therapeutic regimens.