Why the study?
Central blood pressure predicts cardiovascular prognosis better than brachial pressure, but whether the contribution of central pulse pressure to renal events differs from cardiovascular events was unclear.
Do central and brachial pulse pressures predict cardiovascular and renal events in treated hypertensive patients?
Do central and brachial pulse pressures predict cardiovascular and renal events in treated hypertensive patients?
Central and brachial pulse pressures are associated with cardiovascular and renal events in treated hypertensive patients, but the absence of baseline cardiovascular or renal disease is the primary determinant of event-free survival.
Associations attenuated by baseline CVD/creatinine; leaves open incremental prognostic value of pulse pressures in treated hypertension.
Purposes Central blood pressure is a stronger predictor of cardiovascular prognosis rather than brachial blood pressure. The reflection wave reaches the abdominal aorta sooner than ascending aorta. Thus, the contribution of central pulse pressure (cPP) to renal events may differ from that of cardiovascular events.Methods The subanalysis of the ABC-J II study was performed. Subjects were 3434 treated hypertensive patients with a 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 was analysed.Results Cox proportional-hazard analysis revealed that sex (p < 0.001), height (p < 0.05), history of cardiovascular diseases (p < 0.001), number 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. After adjusting for the history of cardiovascular diseases, Cox regression demonstrated only sex as a significant predictor of cardiovascular events. After adjusting for baseline serum creatinine, no parameters were shown to predict 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.
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Takenaka et al. (2022) studied this question.
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