ACE affecting the pulse waveform

The vasodilatory effects and subsequent lowering of myocardial after-load and central pulse pressure of ACE (Ramipril) is visualised within 7 days of starting treatment supporting adherence with the patient and confirms outcomes to the health care professional.

Example of ACE affecting the brachial and aortic pressure waves due to vasodilation after 7 days of treatment.

68 Year old male before ACE

After 7 days Ramipril 2.5mg

ARB affecting the pulse waveform

Response to medical treatment: peripheral curve effected by stopping/starting Losartan 50 mg/day

Antioxidants:

Some vitamins have an important antioxidant function such as vitamin A and its precursors β-carotene, vitamin C, and vitamin E. Vitamin E is thought to prevent atherosclerosis through inhibition of oxidative modification. ¹⁹ ²⁰ Coenzyme Q10 (ubiquinol, CoQ) and lipoic acid in their reduced forms and melatonin are also efficient antioxidants. ²¹

Lifestyle

Losing weight, stop smoking, increase in activity, less alcohol, less stress and anxiety are all associated with decrease in arterial stiffness.

Aerobic exercise where the heart rate is challenged for short periods (20sec) induces release of Nitric Oxide, which vasodilates arteries.

Please note: A health care professional should be consulted before embarking on strenuous exercise for the first time. Stop when chest pain is experienced and consult your GP.

Residual benefit from regular aerobic exercise might take up to three months to take effect.

Examples are: hill running, hill walking, hill cycling; stair climbing, high intensity resistance band workout; kettle bell swings.

4 x 20 Sec hill cycling bouts affecting arterial stiffness and the pulse waveform, lowering BP

Before exercise

After exercise

In conclusion, BP pulsatility, mean BP, and wave reflection are prognostically meaningful, distinct aspects of arterial function that can be used to summarize physiological variations in multiple arterial waveform parameters and identify truly cumulative associations when used as cardiovascular risk outcomes. ²²