کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2951762 1577355 2009 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Impact of Heart Rate on Central Aortic Pressures and Hemodynamics : Analysis From the CAFE (Conduit Artery Function Evaluation) Study: CAFE-Heart Rate
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Impact of Heart Rate on Central Aortic Pressures and Hemodynamics : Analysis From the CAFE (Conduit Artery Function Evaluation) Study: CAFE-Heart Rate
چکیده انگلیسی

ObjectivesThe CAFE (Conduit Artery Function Evaluation) study showed less effective central aortic pressure lowering with atenolol-based therapy versus amlodipine-based therapy in people with hypertension. The present study examined the importance of heart rate (HR) as a determinant of this effect.BackgroundRecent analyses have suggested that beta-blockers are less effective at reducing cardiovascular events than alternative blood pressure (BP)-lowering therapies. There has been much debate about the mechanism for this shortfall in benefit and specifically the role of HR lowering by beta-blockers.MethodsCentral pressures were derived from brachial pressure and radial pulse wave analysis in 2,073 patients, and 7,146 measurements were recorded and analyzed over follow-up for up to 4 years.ResultsThere was no impact of HR on brachial systolic or pulse pressures; however, there was a highly significant inverse relationship between HR and central aortic systolic and pulse pressures (p < 0.001). This was dependent on a strong inverse relationship between HR and augmentation index, indicative of increased wave reflection at lower HRs. Multiple regression, adjusted for brachial BP, showed HR to be the major determinant of central pressures. Moreover, HR and brachial BP accounted for 92% of the variability in central systolic and pulse pressures. Consequently, drug-related differences in central aortic pressures were markedly attenuated after adjustment for HR.ConclusionsWhen comparing beta-blocker–based treatments with other BP-lowering strategies, HR reduction with beta-blockers is a major mechanism accounting for less effective central aortic pressure reduction per unit change in brachial pressure.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 54, Issue 8, 18 August 2009, Pages 705–713
نویسندگان
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