Armstrong, MK;
Schultz, MG;
Hughes, AD;
Picone, DS;
Sharman, JE;
(2021)
Physiological and clinical insights from reservoir-excess pressure analysis.
Journal of Human Hypertension
, 35
pp. 758-768.
10.1038/s41371-021-00515-6.
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Abstract
There is a growing body of evidence indicating that reservoir-excess pressure model parameters provide physiological and clinical insights above and beyond standard blood pressure (BP) and pulse waveform analysis. This information has never been collectively examined and was the aim of this review. Cardiovascular disease is the leading cause of mortality worldwide, with BP as the greatest cardiovascular disease risk factor. However, brachial systolic and diastolic BP provide limited information on the underlying BP waveform, missing important BP-related cardiovascular risk. A comprehensive analysis of the BP waveform is provided by parameters derived via the reservoir-excess pressure model, which include reservoir pressure, excess pressure, and systolic and diastolic rate constants and Pinfinity. These parameters, derived from the arterial BP waveform, provide information on the underlying arterial physiology and ventricular–arterial interactions otherwise missed by conventional BP and waveform indices. Application of the reservoir-excess pressure model in the clinical setting may facilitate a better understanding and earlier identification of cardiovascular dysfunction associated with disease. Indeed, reservoir-excess pressure parameters have been associated with sub-clinical markers of end-organ damage, cardiac and vascular dysfunction, and future cardiovascular events and mortality beyond conventional risk factors. In the future, greater understanding is needed on how the underlying physiology of the reservoir-excess pressure parameters informs cardiovascular disease risk prediction over conventional BP and waveform indices. Additional consideration should be given to the application of the reservoir-excess pressure model in clinical practice using new technologies embedded into conventional BP assessment methods.
| Type: | Article |
|---|---|
| Title: | Physiological and clinical insights from reservoir-excess pressure analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1038/s41371-021-00515-6 |
| Publisher version: | https://doi.org/10.1038/s41371-021-00515-6 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Blood flow, Hypertension, Risk factors |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10124602 |
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