Pedro Forcada
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Papers by Pedro Forcada
technologic progression of the non-invasive vascular evaluation,
in particular the huge step ahead in the last 20 years, in parallel
with the evolution from a “treatment-after- event” based Medicine
to Preventive Medicine. No-invasive vascular Evaluation jumped in
the last twenty years from the bench to the bedside, giving rise to
a Precision Medicine, detecting and preventing the atherosclerotic
disease in the earliest stages, in order to control the huge burden of
cardiovascular disease that the human kind has been suffering the
last hundred years. A worldwide and widespread use of non-invasive
vascular evaluation in the current clinical practice for cardiovascular
prevention remains as a challenge, and this review is a call to action
to do so
linked to the beginning of hypertension and its evolution.
In the near future, simplified and cheaper measurements of both parameters will be used in clinical practice. Their response
to different cardiovascular and non-cardiovascular drugs and the 24-hour monitoring of arterial stiffness markers are now the
new challenges for better and more effective cardiovascular prevention, as they determine the root of the problem, thereby
providing a more effective treatment option based on the physiopathology of the arterial disease..
In hypertension, arterial stiffness evaluation can be particularly useful beyond its prognostic value and for CV risk restratification in three different situations :
1. In young hypertensives to differentiate spurious isolated systolic hypertension from true hypertension.
2. In middle-aged adults, it detects early vascular ageing and allows early intervention and CV risk reduction. An interplay between PWV and augmentation /amplification indexes leads to a better understanding and treatment of vascular
disease as the cause of hypertension.
3. In the elderly, PWV explains the higher pulsatility in isolated systolic hypertension and the main cause of target organ
damage; it is a prognostic marker and a therapeutic target. Eventually, the SUPERNOVA patients could be a group of interest in the future in understanding vascular protection mechanisms
technologic progression of the non-invasive vascular evaluation,
in particular the huge step ahead in the last 20 years, in parallel
with the evolution from a “treatment-after- event” based Medicine
to Preventive Medicine. No-invasive vascular Evaluation jumped in
the last twenty years from the bench to the bedside, giving rise to
a Precision Medicine, detecting and preventing the atherosclerotic
disease in the earliest stages, in order to control the huge burden of
cardiovascular disease that the human kind has been suffering the
last hundred years. A worldwide and widespread use of non-invasive
vascular evaluation in the current clinical practice for cardiovascular
prevention remains as a challenge, and this review is a call to action
to do so
linked to the beginning of hypertension and its evolution.
In the near future, simplified and cheaper measurements of both parameters will be used in clinical practice. Their response
to different cardiovascular and non-cardiovascular drugs and the 24-hour monitoring of arterial stiffness markers are now the
new challenges for better and more effective cardiovascular prevention, as they determine the root of the problem, thereby
providing a more effective treatment option based on the physiopathology of the arterial disease..
In hypertension, arterial stiffness evaluation can be particularly useful beyond its prognostic value and for CV risk restratification in three different situations :
1. In young hypertensives to differentiate spurious isolated systolic hypertension from true hypertension.
2. In middle-aged adults, it detects early vascular ageing and allows early intervention and CV risk reduction. An interplay between PWV and augmentation /amplification indexes leads to a better understanding and treatment of vascular
disease as the cause of hypertension.
3. In the elderly, PWV explains the higher pulsatility in isolated systolic hypertension and the main cause of target organ
damage; it is a prognostic marker and a therapeutic target. Eventually, the SUPERNOVA patients could be a group of interest in the future in understanding vascular protection mechanisms