Key result
24-hour central blood pressure was not better associated with target organ damage (present in 51.4% of patients) than 24-hour peripheral blood pressure.
Why the study?
Does 24-h central blood pressure measurement better associate with target organ damage than 24-h peripheral blood pressure in hypertensive patients?
Cross-Sectional (n=208)
Does 24-h central blood pressure measurement better associate with target organ damage than 24-h peripheral blood pressure in hypertensive patients?
Twenty-four-hour central blood pressure is not superior to peripheral blood pressure in its association with hypertensive target organ damage, suggesting routine 24-h central BP measurement is not supported.
24-h central BP offers no advantage over peripheral for TOD association; leaves open its incremental prognostic value in hypertension.
BACKGROUND AND AIM: Central blood pressure (BP) is increasingly considered as a better estimator of hypertension associated risks. We aimed to evaluate the association of 24-h central BP, in comparison with 24-h peripheral BP, with the presence of target organ damage (TOD). METHODS: Cross-sectional study of 208 hypertensive patients, aged 57 ± 12 years, 34% women. Office (mean of 4 measurements) and 24-h central and peripheral BP were measured by the oscillometric Mobil-O-Graph device. TOD was assessed at cardiac (left ventricular hypertrophy by echocardiography), renal (reduction of glomerular filtration rate and/or microalbuminuria), and arterial (increased aortic pulse wave velocity) levels. RESULTS: A total of 107 patients (51.4%) had TOD (77, 35% patients left ventricular hypertrophy; 54, 25.9% renal abnormalities; and 40, 19.2% arterial stiffness). All SBP and pulse BP estimates (office, 24-h, daytime, and night-time) were associated with the presence of TOD, after adjustment for age, sex, and antihypertensive treatment, with higher odds ratios for ambulatory-derived values. Odds ratios for central and peripheral BP were similar for all office, 24-h, daytime, and night-time BP. After simultaneous adjustment, peripheral, but not central, 24-h and night-time SBP and pulse pressures were associated with the presence of TOD. CONCLUSION: TOD in hypertension is associated with BP elevation, independently of the type of measurement (office or ambulatory, central or peripheral). Central BP, even monitored during 24 h, is not better associated with TOD than peripheral BP. These results do not support a routine measurement of 24-h central BP.
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Sierra et al. (2017) conducted a cross-sectional in Hypertension (n=208). 24-h central blood pressure vs. 24-h peripheral blood pressure was evaluated on Presence of target organ damage (TOD). 24-hour central blood pressure was not better associated with target organ damage (present in 51.4% of patients) than 24-hour peripheral blood pressure.
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