Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality?
OBJECTIVE
To examine the relationship between brachial and central carotid pressures and target organ indices at baseline and their association with future mortality.


METHODS
We examined, cross-sectionally and longitudinally, the relations of baseline systolic and pulse pressures in central (calibrated tonometric carotid pulse) and peripheral (brachial, mercury sphygmomanometer) arteries to baseline left ventricular mass, carotid intima-media thickness, estimated glomerular filtration rate, and 10-year all-cause and cardiovascular mortality in 1272 participants (47% women aged 30-79 years) from a community of homogeneous Chinese.


RESULTS
Left ventricular mass was more strongly related to central and peripheral systolic pressures than pulse pressures. Intima-media thickness and glomerular filtration rate were more strongly related to central pressures than peripheral pressures. A total of 130 participants died, 37 from cardiovascular causes. In univariate analysis, all four blood pressure variables significantly predicted all-cause and cardiovascular mortality. Each blood pressure variable was entered into the multivariate models, both individually and jointly with another blood pressure variable. After adjustment for age, sex, heart rate, BMI, current smoking, glucose, ratio of total cholesterol to high-density lipoprotein cholesterol, carotid-femoral pulse wave velocity, left ventricular mass, intima-media thickness, and glomerular filtration rate, only central systolic pressure consistently and independently predicted cardiovascular mortality (hazards ratio, 1.30 per 10 mmHg). No significant sex interactions were observed in all analyses.


CONCLUSIONS
Systolic and pulse pressures relate differently to different target organs. Central systolic pressure is more valuable than other blood pressure variables in predicting cardiovascular mortality.
Wang
Kang-Ling
KL
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Cheng
Hao-Min
HM
Chuang
Shao-Yuan
SY
Spurgeon
Harold A
HA
Ting
Chih-Tai
CT
Lakatta
Edward G
EG
Yin
Frank C P
FC
Chou
Pesus
P
Chen
Chen-Huan
CH