Central and Brachial Pulse Pressure Predicts Cardiovascular and Renal Events in Treated Hypertensive Patients

Objective: Central blood pressure is a stronger predictor of cardiovascular prognosis rather than brachial blood pressure. Reflection wave reaches abdominal aorta sooner than ascending aorta. Thus, the contribution of central pulse pressure (cPP) to renal events may differ from that to cardiovascular events. Design and method: The subanalysis of ABC-J II study was performed. Subjects were 3434 treated hypertensive patients with mean follow-up of 4.7 years. Left ventricular hypertrophy, an index of cardiovascular risk, correlated with cPP better than central systolic blood pressure in this cohort. The contribution of brachial pulse pressure (bPP) and cPP to cardiovascular and renal events were analysed. Results: Results: Cox proportional-hazard analysis revealed that sex (p<0.001), height (p<0.05), history of cardiovascular diseases (p<0.001), numbers of antihypertensive drugs (p<0.05) and cPP (p<0.05) contributed to cardiovascular events. However, Cox proportional-hazard analysis disclosed that baseline serum creatinine (p<0.001) and bPP (p<0.05) predicted renal events. Conclusions: The present findings support our previous data that the absence of cardiovascular or renal diseases is an important determinant for event-free survival, and suggest that cPP and bPP contribute to cardiovascular and renal events in treated hypertensive patients.