What should a family doctor know about central blood pressure?


  • P.O. Lazarev Bogomolets National Medical University, Kyiv, Ukraine




arterial hypertension, central blood pressure, antihypertensive agents


The article deals with a review of current data about the clinical importance of central blood pressure values in the routine practice of therapeutists. The mechanisms of formation of central blood pressure are considered. The article presents the data on the effect of various classes of antihypertensive agents on the values of peripheral and central blood pressure. The use of diuretics and non-vasodilating beta-blockers does not provide a decrease in central blood pressure proportionally to peripheral blood pressure.


Download data is not yet available.


Lewington S., Clarke R. et al. Age-specific relevance of usual blood pressure to vascular mortality. a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002. 360. 1903-1913.

Turnbull F. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003. 362. 1527-1535.

Brandão A.A., Amodeo C. et al. I Luso-Brazilian Positio­ning on Central Arterial Pressure. Arq. Bras. Cardiol. 2017 Feb. 108(2). 100-108.

Cheng et al. Consensus of the Taiwan Hypertension Society and Taiwan Society of Cardiology on the Clinical Application of Central Blood Pressure in the Management of Hypertension. Acta Cardiol. Sin. 2019 May. 35(3). 234-243.

Roman M.J., Devereux R.B. et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007. 50. 197-203.

Safar M.E., Blacher J. et al. Central pulse pressure and mortality in end-stage renal disease. Hypertension. 2002. 39. 735-738.

Pini R., Cavallini M.C. et al. Central but not brachial blood pressure predicts cardiovascular events in an unselected geriatric population: the ICARe Dicomano Study. J. Am. Coll. Cardiol. 2008. 51. 2432-2439.

Jankowski P., Kawecka-Jaszcz K. et al. Pulsatile but not steady component of blood pressure predicts cardiovascular events in coronary patients. Hypertension. 2008. 51. 848-855.

Hao-Min Cheng et al. Central blood pressure for the ma-nagement of hypertension: Is it a practical clinical tool in current practice? J. Clin. Hypertens. 2020. 22. 391-406.

Morgan T.O., Anderson A.I.E., MacInnis R.J. ACE inhibitors, β-blocking drugs, calcium channel blocking drugs and diuretics for the control of elevated systolic blood pressure in the elderly. Am. J. Hypertens 2001. 14. 241-247.

Deary A.J., Schumann A.L. et al. Double blind, placebo-controlled crossover comparison of five classes of antihypertensive drugs. J. Hypertens. 2002. 20. 771-777.

Morgan T., Lauri J. et al. Effect of different antihypertensive drug classes on central aortic pressure. Am. J. Hypertens. 2004. 17. 118-123.

Williams B. et al. CAFE Investigators: Anglo-Scandinavian Cardiac Outcomes Trial Investigators: CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006. 113(9). 1213-25.

Deary A.J., Schumann A.L. et al. Influence of drugs and gender on the arterial pulse wave and natriuretic peptide secretion in untreated patients with essential hypertension. Clin. Sci. 2002. 103. 493-499.

Mackenzie I.S., McEniery C.M. et al. Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension. Hypertension. 2009. 54. 409-413.

Hirata K., Vlachopoulos C., Adji A., O’Rourke M.F. Benefits from angiotensin-converting enzyme inhibitor ‘beyond blood pressure lowering’: beyond blood pressure or beyond the brachial artery? J. Hypertens. 2005. 23. 551-556.

London G.M., Pannier B. et al. Cardiac hypertrophy, aortic compliance, peripheral resistance, and wave reflection in end-stage renal disease. Comparative effects of ACE inhibition and calcium channel blockade. Circulation. 1994. 90. 2786-2796.

London G.M., Pannier B. et al. Antihypertensive effects and arterial haemodynamic alterations during angiotensin converting enzyme inhibition. J. Hypertens. 1996. 14. 1139-1146.

Mitchell G.F., Izzo J.L.J. et al. Omapatrilat reduces pulse pressure and proximal aortic stiffness in patients with systolic hypertension: results of the conduit hemodynamics of omapatrilat international research study. Circulation. 2002. 105. 2955-2961.

Ahimastos A.A., Natoli A.K. et al. Ramipril reduces large-artery stiffness in peripheral arterial disease and promotes elastogenic remodeling in cell culture. Hypertension. 2005. 45. 1194-1199.

Dart A.M., Cameron J.D. et al. Similar effects of treatment on central and brachial blood pressures in older hypertensive subjects in the Second Australian National Blood Pressure Trial. Hypertension. 2007. 49. 1242-1247.

Aznaouridis K.A., Stamatelopoulos K.S. et al. Acute effects of renin-angiotensin system blockade on arterial function in hypertensive patients. J. Hum. Hypertens. 2007. 21. 654-663.

Jiang X.J., O’Rourke M.F. et al. Superior effect of an angiotensin-converting enzyme inhibitor over a diuretic for reducing aortic systolic pressure. J. Hypertens. 2007. 25. 1095-1099.

Dhakam Z., McEniery C.M. et al. Atenolol and eprosartan: differential effects on central blood pressure and aortic pulse wave velocity. Am. J. Hypertens. 2006. 19. 214-219.

Stokes G.S., Barin E.S., Gilfillan K.L. Effects of isosorbide mononitrate and AII inhibition on pulse wave reflection in hypertension. Hypertension. 2003. 41. 297-301.

Mahmud A., Feely J. Favourable effects on arterial wave reflection and pulse pressure amplification of adding angiotensin II receptor blockade in resistant hypertension. J. Hum. Hypertens. 2000. 14. 541-546.

Asmar R.G., London G.M. et al. Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide combination in hypertensive patient: a comparison with atenolol. Hypertension. 2001. 38. 922-926.

Dhakam Z., Yasmin et al. A comparison of atenolol and nebivolol in isolated systolic hypertension. J. Hypertens. 2008. 26. 351-356.

Polonia J., Barbosa L., Silva J.A., Bertoquini S. Different patterns of peripheral versus central blood pressure in hypertensive patients treated with beta-blockers either with or without vasodilator properties or with angiotensin receptor blockers. Blood Press. Monit. 2010. 15. 235-239.

Shah N.K., Smith S.M. et al. Carvedilol reduces aortic wave reflection and improves left ventricular/vascular coupling: a comparison with atenolol (CENTRAL Study). J. Clin. Hypertens. (Greenwich). 2011. 13. 917-924.

Goupil R. et al. Heart rate dependent and independent effects of beta-blockers on central hemodynamic parameters: A propensity score analysis. Journal of Hypertension. 2016. 34(8). 1535-43.

Vaz-de-Melo R.O., Giollo-Júnior L.T. et al. Nebivolol reduces central blood pressure in stage I hypertensive patients: experimental single cohort study. Sao Paulo Med. J. 2014. 132(5). 290-6.

Topouchian et al. Changes in Arterial Structure and Function Under Trandolapril-Verapamil Combination in Hypertension. Stroke. 1999. 30. 1056-1064.

Pucci G., Ranalli M.G. et al. Effects of β-Blockers With and Without Vasodilating Properties on Central Blood Pressure: Systematic Review and Meta-Analysis of Randomized Trials in Hypertension. Hypertension. 2016 Feb. 67(2). 316-24.



How to Cite

Lazarev, P. (2022). What should a family doctor know about central blood pressure?. HYPERTENSION, 15(1), 4–7. https://doi.org/10.22141/2224-1485.15.1.2022.337




Similar Articles

You may also start an advanced similarity search for this article.