Peripheral, not central, BP correlates better with hypertensive target organ damage
The presence of target organ damage (TOD) in hypertension is more likely to result in blood pressure (BP) elevation, independently of the type of measurement (office or ambulatory, central or peripheral), according to a recent study. Central BP, even monitored during 24 hours, is not better correlated with TOD than peripheral BP.
Researchers performed a cross-sectional study of 208 hypertensive patients (mean age 57±12 years; 34 percent women) to examine the association of 24-hour central BP, in comparison with 24-hour peripheral BP, with the presence of TOD.
The oscillometric Mobil-O-Graph device was used to measure office (mean of four measurements) and 24-hour central and peripheral BP. The investigators assessed TOD at cardiac (left ventricular hypertrophy by echocardiography), renal (reduction of glomerular filtration rate and/or microalbuminuria) and arterial (increased aortic pulse wave velocity) levels.
Of the patients, 107 (51.4 percent) had TOD (77 [35 percent] left ventricular hypertrophy; 54 [25.9 percent] renal abnormalities; 40 [19.2 percent] arterial stiffness).
After adjustment for age, sex and antihypertensive treatment, all systolic (S)BP and pulse BP estimates (office, 24-hour, daytime and night-time) correlated with the presence of TOD, with higher odds ratios (ORs) for ambulatory-derived values.
There were similar ORs for central and peripheral BP for all office, 24-hour, daytime and night-time BP. After simultaneous adjustment, peripheral, but not central, 24-hour and night-time SBP and pulse pressures correlated with the presence of TOD.
These findings do not lend support to a routine measurement of 24-hour central BP, which is increasingly considered as a better estimator of hypertension-associated risks, according to researchers.