Key result
Central SBP improves MACE prediction by a clinically negligible 0.2% over brachial blood pressure.
Why the study?
It was unclear whether the hemodynamic strain indicated by central SBP improves cardiovascular risk stratification over brachial BP, and the optimal central SBP threshold was unknown.
Does central systolic blood pressure better predict major adverse cardiovascular events compared to brachial blood pressure in a general population without prior cardiovascular disease?
Cohort (n=13,461)
Does central systolic blood pressure better predict major adverse cardiovascular events compared to brachial blood pressure in a general population without prior cardiovascular disease?
Effect estimate: Difference in AUC 0.2% (95% CI 0.1-0.3)
p-value: p=<0.01
Central BP measured with a type I device provides statistically significant but clinically negligible improvement over brachial BP for predicting cardiovascular events in a primary prevention population.
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Should not change risk prediction with brachial BP; leaves open whether central measurements extend accuracy in prospective cohorts.
Lamarche et al. (2020) conducted a cohort in General population without prior cardiovascular disease (n=13,461). Central systolic blood pressure vs. Brachial blood pressure was evaluated on major adverse cardiovascular events (Difference in AUC 0.2%, 95% CI 0.1-0.3, p=<0.01). Central systolic blood pressure was statistically but not clinically superior to brachial blood pressure for predicting major adverse cardiovascular events (AUC difference 0.2%; P<0.01).
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