5TH FL Upstate Health Care Center
90 Presidential Plaza
Syracuse, NY 13202

315 464-4535

Clinical Section Affiliations

• Medicine: Cardiology
• Upstate Heart and Vascular Center: Cardiology

Research Programs and Affiliations

• Medicine

Research Interests

• Arterial & aortic distensibility; Hypertension

Research Abstract

Isolated systolic hypertension is a cardiovascular risk factor that is becoming more prevalent as the population ages. This form of hypertension is defined as an elevated systolic pressure, a normal or low diastolic pressure and a wide pulse pressure - a constellation of findings attributed, in large measure, to loss of distensibility of the central aorta that is associated with aging. But techniques to measure central aortic pressure and stiffness in patients are difficult because of their invasive nature. Current efforts have been directed toward developing and validating non-invasive measurements from which aortic pressures and pulses can be calculated. In one of our studies, aortic dimensions and cuff pressures have been measured retrospectively in some 500 transesophageal echocardiograms obtained routinely for a variety of clinical indications. In another series, the differences between cuff and directly recorded aortic systolic blood pressures have been measured at baseline and during infusion of an inotropic agent (Dobutamine). The accuracy of predicted aortic pressures calculated from applanated radial pulses using transfer functions (Sphygmocor device) has also been assessed. Thus far, accuracy of the predicted aortic pressures has been limited and future plans include carotid pulse applanation in an effort to improve the accuracy of the predicted aortic pressures.

 

Selected References

Agabiti-Rosei E, Mancia G, O'Rourke MF, Roman MJ, Safar ME, Smulyan H, Wang JG, Wilkinson IB, Williams B,Vlachopoulos C.  Blood Presssure Measurements and Anti-hypertensive Therapy: A Consensus Document. Hypertension 2007; 50: 154-160.

Avolio AP, Van Bortel LM, Boutouyrie P, Cockcroft JR, McEniery CM, Protogerou AD, Roman MJ, Safar ME, Smulyan H. Role of Pulse Pressure Amplification in Arterial Hypertension. Expert's Opinion and Review of the Data. Hypertension 2009; 54: 375-383.