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The Importance of Measuring the Pulse Pressure

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The Importance of Measuring the Pulse Pressure
Dart and Kingwell review the cause and effect of elevated pulse pressure in the March issue of the Journal of the American College of Cardiology. They address the "chicken and egg" debate about the mechanism responsible for the production of a wide pulse pressure. What comes first? Does the stiffness and poor compliance of the large arteries, such as the aorta, due to a loss in elasticity enhance the development of atherosclerosis, or is atherosclerosis responsible for the poor elasticity?

Regardless of which comes first, the authors re-emphasize that an elevated pulse pressure is a marker for atherosclerosis, including that found in the coronary arteries. They also urge the development of drugs that can be aimed specifically at the treatment of an elevated pulse pressure, and list angiotensin-converting enzyme (ACE) inhibitors as possibly having some effect on the arterial wall itself.

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