Estimation of aortic systolic blood pressure in community-based screening: the relationship between clinical characteristics and peripheral to central blood pressure differences

Nakamura, Motoyuki; Sato, Koetsu; Nagano, Masahide

doi:10.1038/sj.jhh.1001806

Cited by 12 publications

(8 citation statements)

References 8 publications

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“…This central to radial amplification has been shown to be higher in men than in women (20); it is also higher in young people and decreases with age (21), and is affected by height (22) and the heart rate (23). While other articles referred to the difference between the bsBP and csBP as “bsBP - csBP”, we defined our Δ value as “csBP - bsBP” because the csBP was mostly higher than the bsBP in our data.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, we can speculate that the central to radial amplification is larger in taller people, leading to the correlation. Nakamura et al (23) showed that in women, short stature was correlated with low levels of central to peripheral sBP amplification; highlighting that the sex and stature differences were correlated with the brachial-aortic sBP difference. Herbert et al (9) revealed that amplification was higher in males than in females.…”

Section: Discussionmentioning

confidence: 99%

“…On average, men are taller than women; thus, this maybe one of the reasons underlying the sex difference. Furthermore, it was previously pointed out (23) that there are differences in the arterial characteristics of men and women. This difference may have also been a factor in the sex differences observed in the Δ value.…”

Section: Discussionmentioning

confidence: 99%

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The Relationships between the Differences in the Central Blood Pressure and Brachial Blood Pressure and Other Factors in Patients with Essential Hypertension

et al. 2017

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Objective The management of blood pressure (BP) in hypertensive patients is the key to preventing a progression of organ damage. The brachial BP (bBP) has been used as the representative method for measuring the BP. The central BP (cBP), which is, different from the bBP due to the propagation and the reflection of the pulse wave in the arterial system, has recently received attention because it can now be estimated noninvasively. We examined the relationships between the difference in the central systolic BP (csBP) and the brachial systolic BP (bsBP) (Δ) and other factors in hypertensive patients. Methods The bsBP and csBP were measured in patients with essential hypertension and the relationships between the bsBP, csBP, or Δ and background factors including age, the brain natriuretic peptide (BNP) level, the estimated glomerular filtration rate (eGFR), flow-mediated vasodilation (an index of vascular endothelial function), the cardio-ankle vascular index (CAVI, an index of arteriosclerosis), and the carotid intima-media thickness (an index of atherosis) were investigated. Results The data of 191 patients were analyzed. Although there was no significant correlation between the CAVI and the bsBP; positive correlations were observed between the CAVI and the csBP (r=0.249, p=0.001). The Δ value showed significant positive correlations with age, and the BNP, eGFR, and CAVI values. Conclusion The csBP is more strongly associated with arteriosclerosis than the bsBP. Moreover, the Δ value is more strongly associated with cardiac function, renal function, and arteriosclerosis than the bsBP or csBP. These data suggested that the Δ value may have a greater prognostic value than the bsBP or csBP and may be worth calculating in the clinical setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Relationships between the Differences in the Central Blood Pressure and Brachial Blood Pressure and Other Factors in Patients with Essential Hypertension

et al. 2017

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“…22 However, a larger study of relatively healthy subjects with a low rate of hypertension (20%) and LV hypertrophy (5%) showed no significant difference in the prevalence of cardiac hypertrophy when subjects were stratified into quartiles of brachial-aortic SBP difference. 23 Others have shown central pressure waveform indices to be important predictors of LV and carotid artery structure. 24,25 We have also found an independent association between central pulse pressure and LV mass in patients with type 2 diabetes mellitus.…”

Section: Pressure Amplification and Riskmentioning

confidence: 99%

Central blood pressure measurement may improve risk stratification

et al. 2008

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Central systolic blood pressure (SBP) may differ between individuals with similar brachial SBP, which may have implications for risk assessment. This study aimed to determine the variation and potential clinical value of central SBP between patients with similar brachial SBP. Brachial SBP was measured by sphygmomanometer and central SBP by radial tonometry in 675 people (430 men), comprising healthy individuals (n ¼ 222), patients with known or suspected coronary artery disease (n ¼ 229) and diabetes (n ¼ 224). Individuals were stratified by brachial SBP in accordance with European Society of Hypertension guidelines (optimal, normal, high-normal, grades 1, 2 and 3 hypertension). The potential clinical value of central SBP was determined from the percentage of patients re-classified into different brachial SBP groups due to the difference between brachial and aortic SBP (defined as brachial SBP-central SBP). Central SBP increased with each brachial SBP level (optimal to grade 3 hypertension; Po0.001 for all). However, large variation in brachialaortic SBP difference occurred within each brachial SBP group (range 2-33 mm Hg), resulting in sizeable overlap of central SBP between brachial SBP groups. For patients with normal brachial SBP, 96% had central SBP within the range of patients with high-normal brachial SBP, as well as 64% within the range of patients with grade 1 hypertension. We conclude that wide variation in brachial-aortic SBP difference occurs between patients with similar brachial SBP. This results in a significant overlap of central SBP scores between brachial SBP risk groups. This is likely to have treatment implications but remains to be tested.

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“…Thus, aortic BP may differ from systolic BP when measured at the brachial artery. This difference may vary from 1 mmHg to 33 mmHg 41,42. Due to summation (“amplification”) in young and tall individuals, peripheral systolic BP may be higher than normal, while central systolic BP may be normal 24.…”

Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of a fixed-dose combination of losartan + HCTZ versus bisoprolol + HCTZ in patients with moderate-to-severe hypertension: results of the 6-month ELIZA trial

Radchenko¹,

Sirenko²,

Kushnir³

et al. 2013

VHRM

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BackgroundThe aim of this study was to compare the antihypertensive efficacy of losartan 100 mg + hydrochlorothiazide (HCTZ) 25 mg versus bisoprolol 10 mg + HCTZ 25 mg and their influence on arterial stiffness and central blood pressure (BP).MethodsOf 60 patients with a mean BP of 173.3 ± 1.7/98.4 ± 1.2 mmHg, 59 were random-ized to losartan + HCTZ (n = 32) or bisoprolol + HCTZ (n = 27). Amlodipine was added if target BP was not achieved at 1 month, and doxazosin was added if target BP was not achieved after 3 months. Body mass index, office and 24-hour ambulatory BP, pulse wave velocity (carotid-femoral [PWVE] and radial [PWVM]), noninvasive central systolic BP, augmentation index (AIx), laboratory investigations, and electrocardiography were done at baseline and after 6 months of treatment.ResultsLosartan + HCTZ was as effective as bisoprolol + HCTZ, with target office BP achieved in 96.9% and 92.6% of patients and target 24-hour BP in 75% and 66.7% of patients, respectively, after 6 months. Effective treatment of BP led to significant lowering of central systolic BP, but this was decreased to a significantly (P < 0.05) greater extent by losartan + HCTZ (−23.0 ± 2.3 mmHg) than by bisoprolol + HCTZ (−15.4 ± 2.9 mmHg) despite equal lowering of brachial BP. Factors correlated with central systolic BP and its lowering differed between the treatment groups. Losartan + HCTZ did not alter arterial stiffness patterns significantly, but bisoprolol + HCTZ significantly increased AIx. We noted differences in ΔPWVE, ΔPWVM, and ΔAIx between the groups in favor of losartan + HCTZ. Decreased heart rate was associated with higher central systolic BP and AIx in the bisoprolol + HCTZ group, but was not associated with increased AIx in the losartan + HCTZ group.ConclusionAlthough both treatments decreased both office and 24-hour BP, losartan + HCTZ significantly decreased central systolic BP and had a more positive influence on pulse wave velocity, with a less negative effect of decreased heart rate on AIx and central systolic BP.

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Estimation of aortic systolic blood pressure in community-based screening: the relationship between clinical characteristics and peripheral to central blood pressure differences

Cited by 12 publications

References 8 publications

The Relationships between the Differences in the Central Blood Pressure and Brachial Blood Pressure and Other Factors in Patients with Essential Hypertension

The Relationships between the Differences in the Central Blood Pressure and Brachial Blood Pressure and Other Factors in Patients with Essential Hypertension

Central blood pressure measurement may improve risk stratification

Comparative effectiveness of a fixed-dose combination of losartan + HCTZ versus bisoprolol + HCTZ in patients with moderate-to-severe hypertension: results of the 6-month ELIZA trial

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