Central versus ambulatory blood pressure in the prediction of all-cause and cardiovascular mortalities

Chi Ming Huang, Kang Ling Wang, Hao Min Cheng, Shao Yuan Chuang, Shih Hsien Sung, Wen Chung Yu, Chih Tai Ting, Edward G. Lakatta, Frank C.P. Yin, Pesus Chou, Chen Huan Chen

Research output: Contribution to journalArticle

Abstract

Objectives: Central systolic (SBP-C) and/or pulse pressure (PP-C) better predicts cardiovascular events than does peripheral blood pressure. The present study compared the prognostic significance of office central blood pressure with multiple measurements of out-of-office ambulatory peripheral blood pressure, with reference to office peripheral systolic (SBP-B) or pulse pressure (PP-B). Methods: In a community-based population of 1014 healthy participants, SBP-C and PP-C were estimated using carotid tonometry, and 24-h systolic (SBP-24 h) and pulse pressure (PP-24 h) were obtained from 24-h ambulatory blood pressure monitoring. Associations of SBP-B, PP-B, SBP-C, PP-C, SBP-24 h, and PP-24 h with all-cause and cardiovascular mortalities over a median follow-up of 15 years were examined by Cox regression analysis. Results: In multivariate analyses accounting for age, sex, BMI, smoking, fasting plasma glucose, and total cholesterol/high-density lipoprotein cholesterol ratio, only PP-C (hazard ratio 1.16, 95% confidence interval 1.01-1.32, per one standard deviation increment) was significantly predictive of all-cause mortality, whereas all but PP-B were significantly predictive of cardiovascular mortality. When SBP-B was simultaneously included in the models, SBP-24 h (2.01, 1.42-2.85) and SBP-C (1.71, 1.21-2.40) remained significantly predictive of cardiovascular mortality. When SBP-C was simultaneously included in the models, SBP-24 h (1.71, 1.16-2.52) remained significantly predictive of cardiovascular mortality. Conclusion: Office central blood pressure is more valuable than office peripheral blood pressure in the prediction of all-cause and cardiovascular mortalities. Out-of-office ambulatory peripheral blood pressure (SBP-24 h) may be superior to central blood pressure in the prediction of cardiovascular mortality, but PP-C may better predict all-cause mortality than SBP-24 h or PP-24 h.

Original languageEnglish (US)
Pages (from-to)454-459
Number of pages6
JournalJournal of hypertension
Volume29
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

Keywords

  • ambulatory blood pressure
  • central blood pressure
  • mortality
  • pulse pressure
  • target organ damage

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Huang, C. M., Wang, K. L., Cheng, H. M., Chuang, S. Y., Sung, S. H., Yu, W. C., Ting, C. T., Lakatta, E. G., Yin, F. C. P., Chou, P., & Chen, C. H. (2011). Central versus ambulatory blood pressure in the prediction of all-cause and cardiovascular mortalities. Journal of hypertension, 29(3), 454-459. https://doi.org/10.1097/HJH.0b013e3283424b4d