title: Vascular calcification is not associated with increased ambulatory central aortic systolic pressure in prevalent dialysis patients.
abstract: BACKGROUND
  Central aortic systolic pressure (CASP) strongly predicts cardiovascular outcomes. We undertook to measure ambulatory CASP in 74 prevalent dialysis patients using the BPro (HealthStats, Singapore) device. We also determined whether coronary or abdominal aortic calcification was associated with changes in CASP and whether interdialytic CASP predicted ambulatory measurement.
  
  
  METHODS
  All patients underwent computed tomography for coronary calcium score, lateral abdominal radiography for aortic calcium score, echocardiography for left ventricular mass index and ambulatory blood pressure measurement using BPro calibrated to brachial blood pressure. HealthStats was able to convert standard BPro SOFT(®) data into ambulatory CASP.
  
  
  RESULTS
  Ambulatory CASP was not different in those without and with coronary (137.6 vs 141.8 mmHg, respectively, p = 0.6) or aortic (136.6 vs 145.6 mmHg, respectively, p = 0.2) calcification. Furthermore, when expressed as a percentage of brachial systolic blood pressure to control for peripheral blood pressure, any difference in CASP was abolished: CASP: brachial systolic blood pressure ratio = 0.9 across all categories regardless of the presence of coronary or aortic calcification (p = 0.2 and 0.4, respectively). Supporting this finding, left ventricular mass index was also not different in those with or without vascular calcification (p = 0.7 and 0.8 for coronary and aortic calcification). Inter-dialytic office blood pressure and CASP correlated excellently with ambulatory measurements (r = 0.9 for both).
  
  
  CONCLUSIONS
  Vascular calcification was not associated with changes in ambulatory central aortic systolic pressure in this cohort of prevalent dialysis patients. Inter-dialytic blood pressure and CASP correlated very well with ambulatory measurement.
authors.affiliation: 1.Renal Unit, Groote Schuur Hospital, University of Cape Town, South Africa.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Freercks
authors.affiliation: 1.Renal Unit, Groote Schuur Hospital, University of Cape Town, South Africa.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Swanepool
authors.affiliation: 1.Renal Unit, Groote Schuur Hospital, University of Cape Town, South Africa.
authors.forename: Kristy L
authors.initials: KL
authors.lastname: Turest-Swartz
authors.affiliation: 2.School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Henri R O
authors.initials: HR
authors.lastname: Carrara
authors.affiliation: 3.Radiologist, 2-Military Hospital, Cape Town.
authors.forename: Sulaiman
authors.initials: S
authors.lastname: El Moosa
authors.affiliation: 4.Cardiologist, 2-Military Hospital, Cape Town.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Lachman
authors.affiliation: 1.Renal Unit, Groote Schuur Hospital, University of Cape Town, South Africa.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Rayner
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D013599:Systole / Q000502:physiology; D061205:Vascular Calcification / Q000453:epidemiology*