Central hemodynamics and target organ damage in hypertension

Junichiro Hashimoto

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Recent advances in technology have enabled the noninvasive evaluation of pulsatile hemodynamics in the central aorta; namely, central pressure and flow measurements. The central blood pressure represents the true load imposed on the heart, kidney and brain, and the central blood flow influences the local flow into these vital organs. An elevation of the central blood pressure has a direct, adverse impact on the target organ and, thus, the cardiovascular prognosis in patients with hypertension. A decrease in the central blood flow can cause organ dysfunction and failure. The central pressure and flow dynamics were conventionally regarded as unidirectional from the heart to the periphery. However, current evidence suggests that it should be recognized as a bidirectional interplay between the central and peripheral arteries. Specifically, the pressure pulse wave is not only transmitted forward to the periphery but also reflected backward to the central aorta. The flow pulse wave is also composed of the forward and reverse components. Aortic stiffening and arteriolar remodeling due to hypertension not only augment the central pressure by increasing the wave reflection but also may alter the central bidirectional flow, inducing hemodynamic damage/dysfunction in susceptible organs. Therefore, central hemodynamic monitoring has the potential to provide a diagnostic and therapeutic basis for preventing systemic target organ damage and for offering personalized therapy suitable for the arterial properties in each patient with hypertension. This brief review will summarize hypothetical mechanisms for the association between the central hemodynamics and hypertensive organ damage in the heart, kidney and brain.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalTohoku Journal of Experimental Medicine
Volume233
Issue number1
DOIs
Publication statusPublished - 2014

Keywords

  • Aorta
  • Blood flow
  • Blood pressure
  • Cardiovascular disease
  • Pulse wave

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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