title: Aortic, but not brachial blood pressure category enhances the ability to identify target organ changes in normotensives.
abstract: OBJECTIVE
  We sought to determine whether within normal/high-normal blood pressure (BP) ranges (120-139/80-89 mmHg), aortic BP may further refine BP-related cardiovascular risk assessment, as determined from target organ changes.
  
  
  METHODS
  In 1169 participants from a community sample of African ancestry, 319 (27%) of whom had a normal/high-normal BP, aortic BP was determined using radial applanation tonometry and SphygmoCor software, and target organ changes assessed from carotid-femoral pulse wave velocity (PWV) (n = 1025), estimated glomerular filtration rate (eGFR) (n = 944), and left ventricular mass indexed to height (LVMI) (n = 690).
  
  
  RESULTS
  Normal versus high-normal BP categories failed to differentiate between those participants with a BP above optimal values with versus without multivariate-adjusted target organ changes. However, in those with a normal/high-normal BP with aortic SBP values that were less than 95% confidence interval of healthy participants with optimal BP values (45% of those with a normal/high-normal BP), no unadjusted or multivariate adjusted target organ changes were noted. In contrast, those with a normal/high-normal BP with aortic SBP values that exceeded optimal thresholds, demonstrated unadjusted and multivariate adjusted increases in PWV and LVMI and decreases in eGFR (P < 0.05 to P < 0.005 after multivariate adjustments).
  
  
  CONCLUSIONS
  In contrast to normal versus high-normal BP categories which do not clearly distinguish normotensives with from those without organ damage, noninvasively determined aortic BP measurements may refine the ability to detect those with a normal/high-normal BP at risk of BP-related cardiovascular damage.
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, University of the Witwatersrand Medical School, 2193 Johannesburg, South Africa.
authors.forename: Hendrik L
authors.initials: HL
authors.lastname: Booysen
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Norton
authors.forename: Muzi J
authors.initials: MJ
authors.lastname: Maseko
authors.forename: Carlos D
authors.initials: CD
authors.lastname: Libhaber
authors.forename: Olebogeng H I
authors.initials: OH
authors.lastname: Majane
authors.forename: Pinhas
authors.initials: P
authors.lastname: Sareli
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Woodiwiss
mesh_terms: D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure; D001916:Brachial Artery / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006321:Heart / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult