What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=240). Intervention: Clinical factors (office diastolic BP, uncontrolled BP status, resting heart rate, antihypertensive medications). Primary outcome: Central blood pressure exceeding peripheral blood pressure.

What does this research mean for the field?

Approximately half of individuals exhibit higher central than peripheral blood pressure during 24-hour ambulatory monitoring, and the clinical factors driving this discrepancy differ significantly between systolic and diastolic measurements. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To examine factors associated with elevated central blood pressure compared to peripheral blood pressure.

June 3, 2026

Comparing Clinical Factors Influencing the Variations Between Perpheral and Central 24-Hour Ambulatory Blood Pressure Measurements

Key Result

Central systolic blood pressure exceeded peripheral systolic blood pressure in 40.4% of subjects, while central diastolic blood pressure exceeded peripheral diastolic blood pressure in 50.4%.

Key Points

To examine factors associated with elevated central blood pressure compared to peripheral blood pressure.
Data from SiAM-BP registry collected between 2019-2025.
Included 24-hour ambulatory blood pressure measurements with valid records for peripheral and central values.
Participants categorized by blood pressure discrepancies.
40.4% had central systolic BP exceeding peripheral SBP.
50.4% exhibited higher central diastolic BP than peripheral DBP.
Uncontrolled blood pressure and office peripheral DBP positively associated with central systolic surpassing peripheral.

Study Design

Type

Cross-Sectional (n=240)

Structured PICO

What clinical factors influence the variations between peripheral and central 24-hour ambulatory blood pressure measurements?

Population

240 individuals (77.3% with diagnosed hypertension) with valid 24-hour ambulatory blood pressure monitoring records providing both peripheral and central BP values.

Outcome

Determinants associated with elevated central blood pressure relative to peripheral blood pressuresurrogate

Approximately half of subjects exhibited higher central blood pressure compared to peripheral blood pressure, with variations influenced by office diastolic blood pressure, uncontrolled BP status, resting heart rate, and antihypertensive medication dose.

Abstract

Objective: To examine the determinants associated with elevated central blood pressure (cBP) relative to peripheral blood pressure (pBP). Design and method: Data derived from Siriraj Ambulatory Monitoring of Blood Pressure (SiAM-BP) registry were collected during 2019 - 2025 within this cross-sectional study. To be eligible for inclusion, 24-hour ambulatory blood pressure (ABPM) records had to provide both pBP and cBP values, with a minimum requirement of 20 valid daytime readings and 7 valid nighttime readings. The participants were categorized into two groups based on the discrepancy between their 24-hour peripheral and central blood pressure: those with peripheral BP exceeding central BP, and those exhibiting central BP higher than peripheral BP. The baseline characteristics and basic laboratory results were collected. Results: From the initial screening of 242 subjects’ ABPM records, two cases were not met the criteria for valid nighttime blood pressure records. This resulted in a final sample size of 240 for data analysis. Mean age was 51.9 + 16.7 years. Fifty-three percent of them were men. The proportion of previous diagnosed hypertension, diabetes mellitus, and dyslipidemia were 77.3%, 12.6%, and 64%, respectively. The overall mean 24-hour pBP was 126.6 + 14.6/ 76.7 + 10.9 mmHg, whereas the overall mean 24-hour cBP was 123.8 + 13.1/ 75.2 + 12.6 mmHg. The proportion of individuals whose central systolic BP (cSBP) exceeded their peripheral SBP (pSBP) accounted for 40.4% (97 ABPM records). However, 50.4% of them exhibited higher central diastolic BP (cDBP) than their peripheral DBP (pDBP). Multivariable analysis adjusted by mean 24-hour mean arterial pressure and heart rate showed that office pDBP and uncontrolled BP status were independently positive associated factors of the condition of cSBP surpassing pSBP. Office resting heart rate and total dose of antihypertensive medications were inversely associated factors of this condition. Conversely, office pDBP and uncontrolled BP status negatively associated with the condition of cDBP surpassing pDBP. Conclusions: Approximately half of the all subjects exhibited higher cBP compared to pBP. The factors influencing this condition varied depending on whether SBP or DBP was being considered.

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