Arterial Stiffness in Hypertension : Handbook of Hypertension Series Vol.23

-Table of Contents-
I: Basic concepts of pulsatile arterial hemodynamics Principles and
definitions of arterial stiffness, wave reflections and pulse
pressure amplification. Large arteries, microcirculation and the
mechanism of hypertension. Direct measurement of local arterial
stiffness and pulse pressure. Determination of systemic and regional
arterial stiffness. Interrelations of structure and function of large
arteries in epidemiology.


II: Pathophysiological mechanisms Mechanical stress and the arterial
wall. Pulsatile stress, arterial stiffness and endothelial function.
Endothelial-dependent vascular modulation by pulse perfusion. Central
arterial aging: humans to molecules. Elastin, calcium and the
arterial wall. Animal models for studies of arterial stiffness. Renin-
angiotensin system, large arteries and micro-circulation. Arterial
distensibility and the sympathetic nervous system.


III: Arterial stiffness, wave reflections, cardiovascular risk and
end-organ damage Brachial and central pulse pressure and
cardiovascular risk. Large artery stiffness and cardiovascular risk:
introduction to risk assessment and new strategies. Small artery
elasticity index, endothelial function and cardiovascular risk.
Genetic aspects of arterial stiffness and pulse pressure in clinical
hypertension. Heart rate, pulse pressure and arterial stiffness. The
relation of large arterial structure and function to cardiac
hypertrophy in hypertension. Arterial stiffness in chronic heart
failure. Arterial stiffness and various cardiovascular diseases .
Arterial function in end-stage renal disease. Arterial changes in
renal transplantation.Carotid intima-media thickness and arterial
stiffness.


IV: Clinical aspects of arterial stiffness and wave reflections
Aging: a physical perspective. Hypertension in women: is it
different. Arterial stiffness and wave reflections at the different
stages of the hypertensive vascular disease. Diabetes, lipids and
other cardiovascular risk factors.


V: Therapeutic aspects of arterial stiffness and wave reflections
Antihypertensive drug treatment and cardiovascular prevention: an
update including the 2003?004 secondary prevention trials. Changing
concepts on the role of blood pressure reduction in cardiovascular
prevention. Principles of measurement, of preventing, and of treating
arterial stiffness. Nitrates and endothelial function. De-stiffening
strategy using sodium balance and blockade of the rennin뻕ngiotensin
system. Aldosterone antagonists, arterial stiffness and wave
reflections. Drugs acting on collagen cross-linking. Long term
effects of converting enzyme inhibitors, calcium antagonists and beta
blocking agents on peripheral and central arteries. Statins and
arterial stiffness. Non-pharmacological treatment of increased
arterial stiffness and altered wave length reflections.




-Author Information-



By Michel Safar, MD, Chef de Service, Centre de Diagnostic, Hopital
Hotel-Dieu, Paris, France; and Michael F. O'Rourke, MD, DSc, Emeritus
Professor of Medicine, University of New South Wales Cardiologis, St
Vincent's Hospital, Sydney Head, Ventricular-Vascular Interaction
Group, Vicotr Chang REsearch Institute, Sydnedy, Australia