Key result
Cuff-based central systolic blood pressure shows acceptable diagnostic performance for detecting LVH.
Why the study?
Data on the prognostic relevance of central blood pressure compared with brachial blood pressure for predicting organ damage were limited and conflicting, and mostly derived using complex applanation tonometry.
Does central blood pressure measurement using cuff-based oscillometry improve the detection of left ventricular hypertrophy compared to brachial blood pressure in hypertensive patients?
Cross-Sectional (n=300)
Does central blood pressure measurement using cuff-based oscillometry improve the detection of left ventricular hypertrophy compared to brachial blood pressure in hypertensive patients?
Central blood pressure measured by non-invasive cuff-based oscillometry correlates better with left ventricular hypertrophy than traditional brachial blood pressure in hypertensive patients.
Answers are grounded in this paper and cite their sources.
May support cuff-based central SBP for LVH detection in hypertension; leaves open superiority to brachial BP and needs prospective validation.
OBJECTIVE: Limited and conflicting data have been reported on the prognostic relevance of central blood pressure (CBP) compared with brachial blood pressure (BP) in the anticipation of hypertension-mediated organ damage and the majority of data derived using applanation tonometry with its known complexities. The objective of the present study was to investigate the diagnostic factors of left ventricular hypertrophy (LVH) with a special highlight on the utility of non-invasive oscillometric CBP measurement and derived hemodynamic indices compared to brachial BP as indicators of LVH. METHODS: This cross-sectional study included 300 hypertensive patients (mean age 55.3 years, 61.3% female, 51.7% obese) with a mean duration of hypertension was 5.8 years. They underwent measurement of brachial BP, using a mercury sphygmomanometer, and CBP, using a Mobil-O-Graph, alongside the determination of left ventricular (LV) mass by two-dimensional transthoracic echocardiography. LVH and LV geometric patterns were defined by LV mass index/height 2.7 and relative wall thickness. RESULTS: Bivariate then multivariate analysis showed that age, BMI, central systolic BP (SBP), and pulse wave velocity (PWV) were significant determinants of LVH and optimally controlled brachial BP was a significant negative determinant for LVH. Central SBP had an acceptable diagnostic performance to determine LVH in patients with hypertension (AUC = 0.722, 95% confidence interval: 0.618-0.824, SE = 0.21, P -value <0.001). Using one-way ANOVA, a comparison of means among age groups showed that the steady increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients. CONCLUSION: Estimated central SBP using Mobil-O-Graph showed a significantly higher correlation to LVH than brachial SBP values. The consistent increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients.
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Abdelmegid et al. (2023) conducted a cross-sectional in Hypertension (n=300). Central blood pressure measurement by cuff-based oscillometry vs. Brachial blood pressure measurement was evaluated on Left ventricular hypertrophy (LVH) (AUC 0.722, 95% CI 0.618-0.824, p=<0.001). Central systolic blood pressure estimated by cuff-based oscillometry had acceptable diagnostic performance for determining left ventricular hypertrophy.
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