Relation Of Blood Pressure And Organ Damage: Comparison Between Feasible, Noninvasive Central Hemodynamic Measures And Conventional Brachial Measures

Objective:The present cross-sectional study investigated whether central SBP and pulse pressure (PP) measured noninvasively with a novel cuff-based stand-alone monitor are more strongly associated with hypertensive end-organ damage than corresponding brachial measures.Methods:We investigated the cross-sectional association of central versus brachial SBP and PP with echocardiographic left ventricular mass index (LVMI), LV hypertrophy (LVH), carotid intima-media thickness (IMT), and increased IMT (IMT75th percentile) among 246 participants drawn from the general population (mean age 57.2 years, 55.3% women).Results:All blood pressure (BP) measures were positively correlated with LVMI and IMT (P<0.001 for all). Brachial and central SBP correlated equally strongly with LVMI (r=0.42 versus 0.40, P for difference 0.19) and IMT (r=0.32 versus 0.33, P=0.60). However, brachial PP correlated more strongly than central PP with LVMI (r=0.34 versus 0.27, P=0.03) and IMT (r=0.40 versus 0.35, P=0.04). In multivariable-adjusted logistic models, all four BP measures were significantly associated with LVH and increased IMT (P0.03 for all). However, the diagnostic accuracy of logistic regression models that included brachial or central hemodynamic parameters was similar for LVH [area under curve (AUC) for SBP: 0.74 versus 0.76, P=0.16; AUC for PP: 0.75 versus 0.73, P=0.35] and IMT (AUC for SBP: 0.61 versus 0.61, P=0.67; AUC for PP: 0.63 versus 0.61, P=0.29).Conclusion:Our findings suggest that central SBP and PP measured with a stand-alone noninvasive BP monitor do not improve diagnostic accuracy for end-organ damage over corresponding brachial measures.