Key result
24-h average aortic systolic blood pressure demonstrated a higher discriminatory ability to detect left-ventricular hypertrophy than 24-h brachial systolic blood pressure (AUC 0.73 vs 0.69; P=0.007).
Why the study?
Does 24-h average aortic blood pressure associate better with left-ventricular hypertrophy than 24-h average brachial blood pressure in hypertensive patients?
Cross-Sectional (n=229)
Does 24-h average aortic blood pressure associate better with left-ventricular hypertrophy than 24-h average brachial blood pressure in hypertensive patients?
Absolute Event Rate: 0.73% vs 0.69%
p-value: p=0.007
24-hour aortic ambulatory blood pressure monitoring provides better discriminatory ability for detecting left-ventricular hypertrophy compared to standard brachial monitoring.
Aortic ABPM may enhance LVH detection versus brachial; leaves open whether it improves risk stratification or outcomes.
OBJECTIVE: To test the hypothesis that left-ventricular hypertrophy (LVH) is better associated with aortic, than brachial, 24-h average blood pressure (BP) in individuals with hypertension. BACKGROUND: The office aortic BP is associated better with organ damage, such as LVH, than the office brachial BP; whether the 24-h average aortic BP associates better with LVH, than the 24-h average brachial BP, has never been tested. METHODS: Aortic ambulatory BP monitoring (ABPM) was performed with a novel validated oscillometric cuff-based BP recording device, also used for simultaneous brachial ABPM, and the application of pulse wave analysis method. Office brachial and aortic BP were assessed with validated oscillometric recording device and pulse wave analysis, respectively; left-ventricular mass was measured by ultrasound. RESULTS: Regression analysis performed in 229 individuals (aged 54.3 ± 14.6 years; 56% men; 75% hypertensive patients) showed that the 24-h average aortic SBP was significantly better associated with left-ventricular mass index and LVH than the 24-h average brachial, as well as, office (brachial or aortic) SBP, independently of age, sex, obesity or treatment. Receiver operator characteristics curve analysis showed a higher discriminatory ability of 24-h average aortic than brachial SBP to detect the presence of LVH (area under the curve: 0.73 versus 0.69; P = 0.007). A high degree of interindividual overlap regarding aortic 24-h average SBP level was found in individuals in whom the corresponding brachial measurements denoted different hypertension levels. CONCLUSION: These data suggest that aortic ABPM, when compared to brachial ABPM, improves the individualized assessment of the BP-associated heart damage.
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Protogerou et al. (2014) conducted a cross-sectional in Hypertension (n=229). 24-h average aortic systolic blood pressure vs. 24-h average brachial systolic blood pressure was evaluated on Discriminatory ability to detect the presence of left-ventricular hypertrophy (area under the curve) (p=0.007). 24-h average aortic systolic blood pressure demonstrated a higher discriminatory ability to detect left-ventricular hypertrophy than 24-h brachial systolic blood pressure (AUC 0.73 vs 0.69; P=0.007).
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