Pulsatile hemodynamics in hypertension

The hemodynamics of hypertension and antihypertensive therapy have generall y been approached in terms of the steady-flow load on the heart. Recent evi dence, however, suggests that the pulsatile component of hemodynamic load m ay play a fundamental role in both the development and progression of hyper tensive cardiovascular disease and its clinical sequelae, Pulse pressure, a correlate of conduit vessel stiffness, has been shown to be an important i ndependent predictor of clinical events in hypertensive patients and in the general population. Unrecognized effects on pulsatile hemodynamics may acc ount for the differential effects of various agents on left ventricular mas s and events. A better understanding of abnormalities in pulsatile load in hypertension will facilitate risk stratification in and treatment of patien ts with hypertension, Curr Opin Cardiol 1999, 14:361-369 (C) 1999 Lippincot t Williams & Wilkins. Inc.