1B.02: CENTRAL VERSUS PERIPHERAL BLOOD PRESSURE IN PREDICTING TARGET-ORGAN DAMAGE. (June 2015)

• Record Type: Journal Article
• Authors: Kollias, A.; Zeniodi, M.; Lagou, S.; Stergiou, G.S.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000467364.19958.76
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: There is evidence suggesting that central (aortic) blood pressure (BP) is a more accurate index of the hemodynamic stress on target-organs (heart, brain, aorta and kidneys) than peripheral (brachial) BP. A systematic review and meta-analysis of the evidence on the relationship of central versus peripheral BP with target-organ damage was performed. Design and method: A PubMed search (1913–2014) was performed to identify studies reporting comparative data of central versus peripheral BP in terms of their association with several indices of target-organ damage. Correlation coefficients were pooled by random-effects model meta-analysis. Results: Twelve studies assessing echocardiographic left ventricular mass index (n = 6431, pooled age 56.8 [95% CI 51.4, 62.2] years, 50% males, 51% hypertensives, 25% diabetics) showed stronger correlations with central (pooled correlation coefficient r = 0.30; 95% CI 0.23, 0.37; carotid or radial applanation tonometry) versus peripheral systolic BP (r = 0.26; 95% CI 0.19, 0.33; p < 0.01 for coefficients' comparison; z-statistic). Six studies assessing carotid intima-media thickness (n = 3798, pooled age 52.5 [95% CI 49.5, 55.5] years, 54% males, 50% hypertensives, 18% diabetics) showed stronger correlation with central (r = 0.32; 95% CI 0.26, 0.38; carotid or radial applanation tonometry) versus peripheral pulse pressure (r = 0.25; 95% CI 0.21, 0.29; p < 0.01 for coefficients' comparison). Fourteen studies assessing pulse wave velocity (n = 3701, pooled age 55.8 [95% CI 50.7, 60.8] years, 50% males, 53% hypertensives, 29% diabetics, 11% chronic renal insufficiency) revealed slightly stronger correlations with central (pooled correlation coefficient r = 0.42; 95% CI 0.37, 0.48) versus peripheral systolic BP (r = 0.39; 95% CI 0.33, 0.45; p < 0.01 for coefficients' comparison). Four studies assessing urine albumin excretion (n = 3718, pooled age 55.9 [95% CI 49.7, 62] years, 56% males, 69% hypertensives, 40% diabetics, 58% chronic renal insufficiency) reported similar correlations with central (r = 0.22; 95% CI 0.14, 0.29) versus peripheral systolic BP (r = 0.22; 95% CI 0.12, 0.32; p = NS for coefficients' comparison). Conclusions: The available evidence suggests that central BP is slightly but consistently superior to the peripheral BP in predicting preclinical organ damage except for albuminuria.