Central hypertension is a non-negligible cardiovascular risk factor

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Medicine

Background:

• High blood pressure (BP) is a major cardiovascular risk factor.
• The clinical significance of central BP measurement compared to brachial BP is under investigation.
• Understanding central hypertension is key to refining cardiovascular risk stratification.

Purpose of the Study:

• To review the prognosis, diagnosis, and treatment of central hypertension.
• To evaluate the correlation and clinical implications of central versus brachial BP.
• To highlight the importance of central BP assessment in managing hypertensive patients.

Main Methods:

• Review of existing prospective investigations and clinical trial data.
• Analysis of the correlation between central and brachial BP measurements.
• Cross-classification analysis to identify discrepancies in hypertension status.

Main Results:

• Central and brachial BP are closely correlated, with similar associations to adverse outcomes.
• Outcome-driven thresholds for central systolic BP are approximately 10 mmHg lower than brachial.
• Nearly 10% of patients exhibit discrepancies between central and brachial hypertension status.
• Central hypertension independently predicts increased cardiovascular risk, regardless of brachial BP.

Conclusions:

• Central BP assessment is important for managing hypertensive patients, offering prognostic information beyond brachial BP.
• Newer antihypertensive agents show greater efficacy in reducing central BP.
• Further clinical trials are needed to confirm benefits of targeting central hypertension with optimized treatment.