[Arteriell wall-stiffness: a new important cardiovascular risk factor]

In addition to blood pressure (BP), Augmentation index (AIx) and pulse wave velocity (PWV) are two further parameters to assess arterial function. Even so these functions are partly interdependent, each of them is a strong and independent predictor of vascular risk and end organ damage. In consideration of the high general interest in cardiovascular disease, the diagnostic improvement in assessing abnormal vascular function by these new techniques should be promptly put into practice. The earlier the recognition of vascular dysfunction, the better the chance to prevent vascular or end organ damage by treatment. As dysfunction is directly derived from the vessels where damage should be prevented, AIx and PWV are closer to the object of interest than risk scores, containing predominantly variables which are independent of the vascular tree. Furthermore, they should become abnormal prior to anatomic alteration such as plaques and thus are preferable in early risk diagnostics. As long as BP is the only vascular function diagnosed, its value is similar to that of high cholesterol or waist circumference. But in joining AIx and PWV, these parameters present information on vessel wall function, such as elasticity and on unfavourable hemodynamic flow conditions. An advantage of AIx and PWV over BP-recording is their lower variability as shown in a comparison in 97 hypertensive patients. The standard deviation (SD) of three consecutive blood pressure recordings was systolic/diastolic: 8.7/6.0 mmHg, the SD of three consecutive HR-recording 3.2 beats/min, the SD of three AIx-recordings: 3.9% (TensioClinicgerät) and SD of three PWV-recordings: 1.6 m/sec (TensioClinicgerät).