Central and brachial pulse pressure predicts cardiovascular and renal events in treated hypertensive patients

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Updated: Sep 26, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

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Tsuneo Takenaka1, Yoichi Ohno2, Kazuo Eguchi3

  • 1Kokusai Iryo Fukushi Daigaku, Nephrology, Minato-ku, Tokyo, Japan.

Blood Pressure
|April 19, 2022
PubMed

Insights

Central pulse pressure (cPP) and brachial pulse pressure (bPP) predict cardiovascular and renal events in treated hypertensive patients. Absence of prior cardiovascular or renal disease is key for event-free survival.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Central blood pressure is a superior predictor of cardiovascular prognosis compared to brachial blood pressure.
  • The timing of the reflection wave's arrival in the aorta influences the differential contribution of central pulse pressure (cPP) to cardiovascular versus renal events.

Purpose of the Study:

  • To investigate the distinct contributions of central pulse pressure (cPP) and brachial pulse pressure (bPP) to cardiovascular and renal events in treated hypertensive patients.
  • To assess the correlation between left ventricular hypertrophy and cPP versus central systolic blood pressure.

Main Methods:

  • Subanalysis of the ABC-J II study involving 3434 treated hypertensive patients with a mean follow-up of 4.7 years.
  • Cox proportional-hazard analysis to identify predictors of cardiovascular and renal events.
  • Analysis of the relationship between left ventricular hypertrophy and cPP.

Main Results:

  • Central pulse pressure (cPP) and brachial pulse pressure (bPP) were found to contribute to cardiovascular and renal events, respectively.
  • Sex, height, cardiovascular disease history, number of antihypertensive drugs, and cPP predicted cardiovascular events.
  • Baseline serum creatinine and bPP predicted renal events.

Conclusions:

  • The absence of pre-existing cardiovascular or renal diseases is a significant determinant of event-free survival in treated hypertensive patients.
  • Both cPP and bPP play a role in the occurrence of cardiovascular and renal events, respectively, in this patient cohort.
Abstract

Keywords:
Blood pressurechronic kidney diseasestiffness gradient

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