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Central Systolic Hypertension in Patients with Well-Controlled Hypertension
Jozef Bulas1, Mária Potočárová1, Ján Murín1
11st Department of Internal Medicine, Comenius University, Faculty of Medicine, Mickiewiczova 13, 813 69 Bratislava, Slovakia.
Insights
Many treated hypertensive patients exceed target central systolic blood pressure (CSBP). Adjusting for sex and height is crucial for accurate CSBP classification, as differences significantly impact results.
Area of Science:
- Cardiology
- Hypertension Research
- Vascular Physiology
Background:
- Central systolic blood pressure (CSBP) is a significant prognostic indicator.
- Recent advancements include simplified devices for CSBP estimation.
- Assessing target CSBP achievement in treated hypertensive individuals is essential.
Purpose of the Study:
- To evaluate the achievement of target central systolic blood pressure (CSBP) in treated hypertensive patients.
- To investigate the influence of sex and height on CSBP measurements.
- To determine the relationship between CSBP and brachial blood pressure.
Main Methods:
- Analysis of 100 well-controlled hypertensive patients.
- Utilized the Arteriograph device for CSBP estimation via a single-point measurement approach.
- Employed standard and sex-specific cut-off values for hypertension classification.
Main Results:
- 62% of patients exceeded the general CSBP cut-off of 130 mmHg.
- Using sex-specific cut-offs (≥137 mmHg for females, ≥133 mmHg for males), only 13% remained hypertensive.
- CSBP was higher than brachial pressure in 55% of patients and associated with sex, height, and wave reflection time.
Conclusions:
- A substantial proportion of treated hypertensive patients exhibit elevated CSBP compared to brachial BP.
- CSBP is influenced by sex, height, and wave reflection dynamics.
- Incorporating sex and height into CSBP classification is vital for accurate assessment and management of hypertension.
Abstract:
Background. Central systolic blood pressure (CSBP) has prognostic significance and simplified devices for its estimation have been introduced recently. The aim of this study was to assess the achievement of the target CSBP in treated hypertensive patients. Subjects and Methods. One hundred patients with well-controlled hypertension were analysed. For CSBP estimation, we used the Arteriograph (TensioMed Ltd.), which uses one cuff for all measurements, the "single-point measurement" approach. Results. We found that 62% of patients had CSBP ≥ 130 mmHg, the suggested cut-off value for hypertension. When sex-specific classification was employed (CSBP ≥ 137 mmHg for female and CSBP ≥ 133 mmHg for male), only 13% of patients (mainly women) remained in the hypertensive range. We also found that 55% of patients had a CSBP higher than brachial pressure. Multiple analyses showed that CSBP was significantly associated with sex, height, and return time. Conclusions. A high proportion of treated hypertensive patients had CSBP levels that exceeded their brachial BP. CSBP positively correlated with lower height and shorter return time of the reflected pressure wave and was significantly higher in females compared to males. These findings suggest that, for CSBP classification, it is important to take height and sex-specific differences into account.
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