Hypertensive target organ damage is better associated with central than brachial blood pressure: The Northern Shanghai Study

Area of Science:

• Cardiology
• Gerontology
• Hypertension Research

Background:

• Elevated blood pressure (BP) is a major risk factor for target organ damage (TOD).
• Central BP measurements may offer superior prognostic information compared to brachial BP.
• Assessing TOD in elderly populations is crucial for cardiovascular risk stratification.

Purpose of the Study:

• To compare the association of central and brachial BP with various forms of TOD.
• To evaluate the predictive value of central vs. brachial BP for TOD in an elderly cohort.
• To determine which BP measurement is more strongly linked to hypertensive TOD in older adults.

Main Methods:

• Community-based study of 1599 elderly participants (mean age 71.4 years) in northern Shanghai.
• Assessment of TOD including left ventricular hypertrophy, diastolic dysfunction, carotid plaque, arteriosclerosis, and microalbuminuria.
• Statistical analysis using full-model and stepwise regression, and receiver operating characteristic (ROC) analyses.

Main Results:

• Both central and brachial BP correlated significantly with TOD.
• Central BP was significantly associated with all assessed TOD, while brachial BP was only associated with left ventricular hypertrophy and arteriosclerosis.
• ROC analyses showed central BP identified arteriosclerosis and microalbuminuria more effectively than brachial BP.

Conclusions:

• Central BP demonstrates superiority over brachial BP in its association with hypertensive target organ damage in the elderly.
• Central BP measurement may be a more valuable tool for assessing cardiovascular risk and guiding treatment in older hypertensive patients.
• These findings underscore the clinical significance of central BP monitoring in geriatric cardiovascular health.