Relation of central and brachial blood pressure to left ventricular hypertrophy. The Czech Post-MONICA Study

Area of Science:

• Cardiology
• Hypertension Research
• Medical Diagnostics

Background:

• Central blood pressure (BP) is a superior predictor of cardiovascular events and target organ damage compared to brachial BP.
• The predictive value of central BP for left ventricular hypertrophy (LVH) determined by electrocardiography (ECG) remains unclear.

Purpose of the Study:

• To investigate whether central BP is a better predictor of ECG-determined LVH than brachial BP.
• To assess the association between central and brachial BP and LVH in different age groups.

Main Methods:

• Radial applanation tonometry and ECG were performed on 728 subjects from the Czech Post-MONICA Study.
• LVH was determined using the Sokolow-Lyon index and Cornell product; central BP was derived from radial pulse.
• Multiple linear regression and binary logistic regression analyses were used, adjusting for covariates.

Main Results:

• In individuals over 45 years, LVH was associated with higher central and brachial BP.
• Central systolic pressure showed a higher odds ratio for LVH prediction than brachial systolic and pulse pressure in this age group.
• In individuals under 45 years, LVH was not associated with central or brachial BP, but rather with male sex and low BMI.

Conclusions:

• Noninvasively determined central BP is more strongly related to ECG-determined LVH than brachial BP in subjects over 45 years.
• This finding supports a closer association between central BP and target organ damage.
• Voltage criteria for LVH are not independently associated with central or brachial BP in younger individuals.