INTRODUCTION
High blood pressure, or hypertension, is a major risk factor for coronary heart disease and is one of the most treatable forms of cardiovascular disease. Historically, blood pressure (BP) has been measured at the periphery in the brachial artery and is considered an accurate measure of diastolic BP. However, peripherally measured BP may not accurately reflect systolic BP, as this measure does not take into account the duration of systole or the shape of the systolic wave. More importantly, this measure provides a poor estimate of central aortic systolic pressure, an important factor for determining cardiac function and work.

Central aortic pressure can be derived noninvasively by examining the shape of the pulse wave at the wrist. Interestingly, different classes of antihypertensive drugs produce different BP effects peripherally (brachial BP) vs centrally (aortic BP). Data from the Conduit Artery Function Evaluation (CAFE) trial, a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), suggested that certain drug classes may be more effective than others at reducing central aortic pressure and that the reduction of central aortic pressure may lead to important clinical outcomes.

A better understanding of the importance of central aortic pressure, including the differential effects that antihypertensive drugs have on this measure and the clinical relevance of these data, is therefore essential.

Medscape designates this educational activity for a maximum of 1 AMA PRA Category 1 Credits™. Please note that the course is accredited only for physicians (MD, DO, or equivalent). All other participants receive a certificate of completion.

This activity is composed of the following audio/slide presentations:

• Brachial and Central Pulse Pressure: How Does This Relate to Cardiovascular Risk? (Stanley S. Franklin, MD, FACC, FACP)
  
  
• Central Blood Pressure: What Are the Normal Values?
  (Ian B. Wilkinson, MA, DM, MRCP)
  
  
• Importance of Central Pressure: Recent Clinical Findings (Richard B. Devereux, MD)
  
  
• Panel Discussion/Q&A

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