How Drugs Influencing Central Blood Pressure Prevent Atherosclerosis Complications?

Although the differences between central and peripheral blood pressure (BP) have been known for decades, the consequences of decision-making based on peripheral rather than central BP have only recently been recognized. Central PP is closer to the heart, coronary and carotid arteries, which are the most important sites of cardiovascular events. The influence of cyclic stretch (owing to cyclic changes in BP) on the arterial wall has been documented at every stage of atherosclerosis development. Apart from mediating atherosclerosis progression and plaque instability, the pulsatile component of BP is the main mechanism leading to plaque rupture and, consequently, to acute coronary syndromes and other vascular complications. Latest evidence suggests that the effect of some antihypertensive drugs on central BP (especially on central pulse pressure) is greater when compared with the effect on peripheral pressure, especially if systolic or pulse pressure are measured. Recently, a new group of drugs (advanced glycation end products cross-link breakers) were developed which have ability to decrease pulsatile component of blood pressure. The principal goal of the present review is to update the latest advances in this field.