[Clinical implications of central blood pressure]

The diagnosis and the treatment of hypertension are based on blood pressure readings traditionally taken at the level of the brachial artery. It is currently possible to determine central blood pressure using the aplanation tonometry technique and applying a transfer function to calculate the impact of reflecting waves on pressure prevailing in thoracic aorta. The reflected waves which reach the thoracic aorta in systole are more marked when the stiffness of the arterial wall is increased, leading to augmentation of central systolic blood pressure. Recent clinical trials have shown that, for the same decrease in peripheral blood pressure, different therapeutic strategies do not necessarily impact identically on central blood pressure. This fact might influence their ability to prevent cardiovascular complications.