Cardiovascular End Points and Mortality Are Not Closer Associated With Central Than Peripheral Pulsatile Blood...

Area of Science:

• Cardiovascular Medicine
• Hypertension Research
• Clinical Epidemiology

Background:

• Pulsatile blood pressure (BP) is a known cardiovascular risk factor.
• Uncertainty exists regarding whether central systolic BP (cSBP) or central pulse pressure (cPP) offer tighter associations with cardiovascular end points compared to peripheral measurements (pSBP and pPP).

Purpose of the Study:

• To investigate if central systolic blood pressure and central pulse pressure are more strongly associated with cardiovascular outcomes than their peripheral counterparts.

Main Methods:

• Analysis of data from nine studies involving 5608 participants with a median follow-up of 4.1 years.
• Central BP (cSBP, cPP) and peripheral BP (pSBP, pPP) were measured.
• Hazard ratios were calculated for cardiovascular end points per 1-SD increment in BP, with adjustments for covariates.

Main Results:

• Cardiovascular event rates increased exponentially with higher central pulse pressure.
• Multivariable-adjusted hazard ratios per 1-SD increment were significant for cSBP (1.50), cPP (1.36), pSBP (1.49), and pPP (1.34).
• Adjusting for peripheral BP removed the significance of central BP associations, and vice versa, indicating no independent predictive value of central over peripheral measures.

Conclusions:

• Associations between systolic blood pressure and pulse pressure with cardiovascular and mortality end points are not stronger when measured centrally compared to peripherally.
• Neither central systolic BP nor central pulse pressure independently predict cardiovascular risk beyond peripheral measurements.