Abstract
Almost all hypertension treatment studies have utilised conventional sphygmomanometry to measure the effect of different drug therapies on blood pressure and morbidity and mortality. It is likely, however, that conventional peripheral blood pressure measurements are an imperfect surrogate measure of central arterial blood pressure. It is also possible that various therapeutic regimes have differing effects of large vessel performance and the resulting haemodynamic indices. Thus, if central arterial blood pressure could be conveniently measured, it may provide a better marker of cardiovascular risk and the response to antihypertensive and lipid lowering therapy. Nevertheless, this remains speculative because to date, the relationship between treated peripheral blood pressure measurements and simultaneous central arterial pressure estimation have not been defined in a large prospective clinical trial. This ASCOT sub-study will use non-invasive applanation tonometry to acquire peripheral (radial) arterial pressure wave forms to calculate central arterial pressure. In addition, pulse wave analysis will provide information about large vessel haemodynamic performance and arterial pulse wave augmentation; a surrogate for large vessel compliance. The design of ASCOT will allow the prospective examination of the impact of two different antihypertensive therapy regimes on pulse wave morphology in a large cohort of hypertensive patients at high cardiovascular risk. The impact of statin therapy and the resultant lipid lowering on vascular function and central arterial pressure indices will also be defined. Moreover the relationship between the effects of these different therapeutic inter-
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