Invited review
Central haemodynamics of hypertension

Invasive data on central haemodynamics in healthy normotensive subjects are scarce, and studies in hypertensives are limited as well. A summary of the available data on central haemodynamics in hypertensives and nor-motensives in the same age groups is presented. Hypertension reflects a disturbance in the balance between cardiac output (CO) and total peripheral resistance (TPR), ranging from a pattern of high CO and normal TPR in young age and early hypertension, to a normal-to-low CO and high TPR in more established hypertension. An early sign of impairment of cardiac pump function in hypertension is most readily seen in stroke volume, particularly during exercise. Drug therapy may reduce blood pressure in hypertensives by reducing CO, TPR, or both. Ideally a perfect antihypertensive agent should be able to reduce blood pressure to normal level by reducing TPR and restoring normal cardiac pump function both at rest and during exercise. But so far, no ideal drug has been found that can fully normalize the haemodynamic disturbance of hypertension.