New insights into cardiovascular risk from the exercise central waveform

Numerous studies in healthy individuals with normal office blood pressure (BP) have shown that a hypertensive response to exercise predicts the future onset of hypertension, as well as cardiovascular morbidity and mortality, independent of office BP. The mechanisms underlying the predictive value of exercise BP are incompletely understood. However, it has been proposed that the additional cardiovascular stress imposed by exercise may unmask the presence of concealed hypertension. A new non-invasive method of exercise arterial pressure waveform analysis (and central BP estimation) may provide additional clinical information, as well as insight into mechanisms, beyond the BP obtained by traditional upper arm cuff methods.