Arterial Stiffness

Obtaining arterial stiffness indices from simple arm cuff measurements: the holy grail? Pierre Boutouyriea,b, Miriam Reverac,d and Gianfranco Paratic,d Journal of Hypertension 2009, 27:2159–2161 aUniversite´ Paris Descartes; INSERM, U970, bDepartment of Pharmacology, Assistance Publique-Hoˆ pitaux de Paris, Hoˆ pital Europe´en Georges Pompidou, Paris, France, cDepartment of Clinical Medicine and Prevention, Milano-Bicocca University and dDepartment of Cardiology, IRCCS San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy Correspondence to Professor Gianfranco Parati, MD, Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, Via Spagnoletto 3, 20149 Milan, Italy Tel: +39 02 6191 12890; fax: +39 02 6191 12956; e-mail: gianfranco.parati@unimib.it See original paper on page 2186 Precise assessment of cardiovascular risk factors is a necessary step for the identification of patients at high risk of developing cardiovascular events. When setting the operating curve of the risk function, measurement of blood glucose and lipids, estimation of blood pressure (BP) levels, identification of smoking status, and assessment of existing organ damage represent the main determinants of the tendency to develop cardiac and vascular problems over and above the impact of nonmodifiable factors such as age and sex. Each of these classical risk factors is included in a risk function specific to a given population and aimed at yielding absolute quantitative values of cardiovascular risk [1,2]. Such an approach, in spite of its clinical usefulness, is affected by important limitations. This is because the importance of any modifiable risk factor and its ill effects is highly variable in individual patients, with most of their risk level depending on nonmodifiable characteristics and/or on the complex interaction between a variety of mechanisms. The usual and disappointing result of this classical approach to cardiovascular risk assessment is the possibility to target a very small number of patients at a very high risk only. This allows prevention of only a minority of the total burden of cardiovascular events, as most of them occur in the large majority of patients with only marginally elevated