Table of Contents

SECTION I.
Basic concepts and pathophysiological mechanisms of PAH.
Principles and definitions of arterial stiffness, wave reflections and pulse pressure amplification.
Large arteries, microcirculation and the mechanism of hypertension.
Direct measurement of local arterial stiffness and pulse pressure.
Determination of systemic and regional arterial stiffness.
Calcifications.
Mechanical stress and the arterial wall.
Pulsatile stress, arterial stiffness and endothelial function.
Endothelial-dependent vascular modulation by pulse perfusion.
Central arterial aging: humans to molecules.
Elastin, calcium and the arterial wall.
Animals models for studies of arterial stiffness.
Renin-angiotensin system, large arteries and microcirculation.
Arterial distensibility and the sympathetic nervous system.
SECTION II.
Clinical aspects and end-organ damage in PAH.
Brachial and central pulse pressure, and cardiovascular risk.
Large artery stiffness and cardiovascular risk: Introduction to risk assessment and new strategies.
Therapeutic trials and cardiovascular risk.
Genetic aspects of arterial stiffness and pulse pressure in clinical hypertension.
Heart rate, pulse pressure and arterial stiffness.
The relation of large arterial structure and function to cardiac hypertrophy in hypertension.
Arterial stiffness in hypertension and chronic heart failure.
Arterial stiffness and various cardiovascular diseases.
Arterial function in end-stage renal disease.
Arterial changes in renal transplantation.
Carotid cerebral circulation and arterial stiffness.
Aging process.
Hypertension in women: is it different?.
Arterial stiffness and wave reflections at the different stages of the hypertensive vascular disease.
Diabetes, (lipids) and other cardiovascular risk factors.
Pulsatile hemodynamics and thrombino formation.
Lipids and atherosclerotic disease.
SECTION III.
Clinical pharmacology and therapeutics of PAH.
Antihypertensive drug treatment and cardiovascular prevention: an update including the 2003-2004 secondary prevention trials.
Changing concepts on the role of blood pressure reduction in cardiovascular prevention.
Principles of measurement, preventing and treating arterial stiffness.
Nitrates and endothelial function.
De-stiffening strategy, sodium balance and blockade of the renin-angiotensin system.
Aldosterone antagonists, arterial stiffness and wave reflections.
Drugs acting on collagen cross-linking.
Long-term effects of converting enzyme inhibitors, calcium antagonists and b-blocking agents on peripheral and central arteries.
Statins and arterial stiffness.
Nonpharmacological treatment of increased arterial stiffness and altered wave reflections.
BP variability. In cardiovascular prevention, therehastraditionallybeena small number of cardiovascular risk factors to evaluate and manage, such as hypertension, diabetes,hyperlipidemiaand smoking. Recently, it has been recognized that new mechanical factors should be identified, andspecificallyinvolves pulsatile arterial hemodynamic parameters, such asarterial stiffness, pulse pressure and, to a lesser extent, augmentation index and pulse pressure amplification. Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseaseshas been written to facilitate understanding of these new concepts regarding bleed pressure and cardiac risk, and prepare the reader for the considerable evolution of the topic in the years to come.Much has been learned already regarding the management of these patients, and this book presents extensive data on the techniques needed to maximize their outcomes.