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Non-Invasive Central Blood Pressure and Intracranial Waveform Assessment in Hypertensive Patients: A Cross-Sectional
Sayuri Inuzuka1, Mikaelle Costa Correia1, Matheus Martins da Costa1
1Unidade de Hipertensão Arterial - Universidade Federal de Goiás, Goiânia, GO - Brasil.
Insights
Central systolic blood pressure is more strongly associated with intracranial hypertension than peripheral measurements in long-term hypertensive patients. This finding suggests central blood pressure monitoring may be crucial for managing cerebrovascular risk.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Hypertension Research
Background:
- Hypertension is strongly linked to cerebrovascular diseases like stroke and cognitive impairment.
- The precise mechanisms underlying this relationship remain incompletely understood.
- Investigating intracranial pressure (ICP) in hypertensive patients is crucial for understanding cerebrovascular damage.
Purpose of the Study:
- To investigate the relationship between central and peripheral blood pressure (BP) and arterial stiffness with intracranial pressure (ICP).
- To analyze these relationships specifically in patients with long-term chronic hypertension.
- To determine if central BP measurements offer better insights into intracranial hypertension (ICHT) than peripheral ones.
Main Methods:
- Adult patients with long-term hypertension were consecutively enrolled between November 2022 and August 2023.
- Intracranial hypertension (ICHT) was defined using the P2/P1 ratio (> 1.2) and time to peak (TTP) (> 0.25).
- Statistical analysis with a significance level of 5% was employed to assess correlations between BP parameters, arterial stiffness, and ICHT.
Main Results:
- 145 long-term hypertensive patients (average diagnosis duration 20 years) were evaluated.
- Patients with ICHT (based on P2/P1 ratio) exhibited higher central systolic BP (SBP), central diastolic BP (DBP), and peripheral DBP.
- Median P2/P1 ratio was 1.4 and median TTP was 0.24, indicating a prevalence of elevated ICP markers.
Conclusions:
- Central SBP is more closely associated with ICHT than peripheral SBP measurements in hypertensive patients.
- Diastolic BP measurements showed similar associations between central and peripheral readings.
- The findings question the optimal BP assessment method for hypertensive patients with cerebrovascular damage, highlighting central BP's significance.
Background:
There is a strong association between hypertension and cerebrovascular disease, mainly with stroke and cognitive impairment. However, but the mechanistic of this relationship are not completely understood.
Objective:
To analyze the relationship of central, peripheral blood pressure (BP) and arterial stiffness, with intracranial pressure (ICP) in long-term chronic hypertensive patients.
Methods:
Adult individuals were consecutively included in the study from November 2022 to August 2023. The cut-off point identified to define intracranial hypertension (ICHT) by the wave peak (P2/P1) ratio was > 1.2, and the cut-off for time to peak (TTP) was > 0.25. The level of significance adopted in the statistical analysis was 5%.
Results:
A total of 145 patients (32 male, 113 female) with long-term hypertension (average of time since diagnoses 20 ± 12 years) were evaluated over a period of 10 months. The median age was 69.0 (61.8 - 75.7) years and median body mass index 29.0 (25.4 - 33.1) kg/m2. Median value of P2/P1 ratio for all cohort was 1.4 (1.2 - 1.5) and TTP 0.24 (0.21 - 0.29). The analysis was performed considering presence or not of ICHT, and parameters of central BP and pulse wave velocity. There was higher central systolic (SBP), diastolic blood pressure (DBP), and peripheral DBP among patients with ICHT based on the P2/P1 ratio.
Conclusions:
Central SBP levels are more linked to ICHT than office peripheral SBP measurements, while DBP measurements are similar, raising questions about the most suitable BP assessment method for hypertensive patients with cerebrovascular damage.
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