title: Central blood pressure: a powerful predictor of the development of hypertension.
abstract: We examined whether the central aortic systolic blood pressure, a marker of the function of the systemic arterial tree, might be a more powerful predictor of the development of hypertension than the brachial-ankle pulse wave velocity, a marker of the stiffness of the large- to middle-sized arteries, independent of the conventional risk factors for the development of hypertension. In 1268 Japanese men without hypertension (43±8 years old), the relationships between three variables (the second peak of the radial pressure waveform (SP2), brachial-ankle pulse wave velocity and conventional risk factors measured at the first examination) with the presence of hypertension at the second examination (after 3 years' follow-up) were examined. Hypertension was detected at the second examination in 154 men. The best cutoff points of the brachial-ankle pulse wave velocity and SP2, for predicting the development of hypertension, were 12.7 m/s and 109 mm Hg, respectively. The results of a logistic regression analysis confirmed that an SP2 of ≥109 mm Hg (odds ratio=8.493, P<0.001) was a more powerful predictor of the development of hypertension than a brachial-ankle pulse wave velocity of ≥12.7 m/s, independent of the conventional risk factors. The net reclassification index of SP2 (at the best cutoff point) to brachial-ankle pulse wave velocity was 0.211 (P<0.001), indicating that SP2 is a better predictor of the development of hypertension than brachial-ankle pulse wave velocity. In middle-aged Japanese men without hypertension, SP2 may be a more powerful predictor of the development of hypertension than the assessment of stiffness in large to middle-sized arteries independent of the conventional risk factors.
authors.affiliation: Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan. tomiyama@tokyo-med.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomiyama
authors.forename: Michael F
authors.initials: MF
authors.lastname: O'rourke
authors.forename: Hideki
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Chisa
authors.initials: C
authors.lastname: Matsumoto
authors.forename: Mari
authors.initials: M
authors.lastname: Odaira
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Kazuki
authors.initials: K
authors.lastname: Shiina
authors.forename: Mikio
authors.initials: M
authors.lastname: Nagata
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D055109:Ankle Brachial Index; D044466:Asian People / Q000706:statistics & numerical data; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*