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European Heart Journal 1990 11(Supplement G):24-28; doi:10.1093/eurheartj/11.suppl_G.24
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Coupling between the left ventricle and arterial system in hypertension

M. O'Rourke

Medical Professorial Unit, St Vincent's Hospital Sydney, New South Wales, Australia

Correspondence: Michael O'Rourke MD, Medical Professorial Unit, St Vincent's Hospital, Sydney, New South Wales 2010, Australia

In youth and in health, a variety of factors combine to optimize coupling between the left ventricle and systemic circulation. In hypertension and with aging, optimal coupling is disturbed by increased arterial stiffness which increases systolic pressure through two different mechanisms. The first mechanism (reduced aortic compliance) is not directly affected by drugs, bur the second (early wave relection) is capable of modification by vasodilator therapy. Favourable effecfs of vasodilator agents may not be apparent when pressure is recorded conventionally in a peripheral artery but can be inferred from consideration of pressure wave contour. Recognition of these factors provides new strategies for dealing with hypertension and hypertensive heart failure in man.

Key Words: Pluse wave velocity • aortic impedance • aortic stiffness • wave reflection • vasodilation


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