title: Left-ventricular hypertrophy is associated better with 24-h aortic pressure than 24-h brachial pressure in hypertensive patients: the SAFAR study.
abstract: OBJECTIVE
  To test the hypothesis that left-ventricular hypertrophy (LVH) is better associated with aortic, than brachial, 24-h average blood pressure (BP) in individuals with hypertension.
  
  
  BACKGROUND
  The office aortic BP is associated better with organ damage, such as LVH, than the office brachial BP; whether the 24-h average aortic BP associates better with LVH, than the 24-h average brachial BP, has never been tested.
  
  
  METHODS
  Aortic ambulatory BP monitoring (ABPM) was performed with a novel validated oscillometric cuff-based BP recording device, also used for simultaneous brachial ABPM, and the application of pulse wave analysis method. Office brachial and aortic BP were assessed with validated oscillometric recording device and pulse wave analysis, respectively; left-ventricular mass was measured by ultrasound.
  
  
  RESULTS
  Regression analysis performed in 229 individuals (aged 54.3 ± 14.6 years; 56% men; 75% hypertensive patients) showed that the 24-h average aortic SBP was significantly better associated with left-ventricular mass index and LVH than the 24-h average brachial, as well as, office (brachial or aortic) SBP, independently of age, sex, obesity or treatment. Receiver operator characteristics curve analysis showed a higher discriminatory ability of 24-h average aortic than brachial SBP to detect the presence of LVH (area under the curve: 0.73 versus 0.69; P = 0.007). A high degree of interindividual overlap regarding aortic 24-h average SBP level was found in individuals in whom the corresponding brachial measurements denoted different hypertension levels.
  
  
  CONCLUSIONS
  These data suggest that aortic ABPM, when compared to brachial ABPM, improves the individualized assessment of the BP-associated heart damage.
authors.affiliation: aHypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, 'Laiko' Hospital, Medical School bBiomedical Engineering Unit, 1st Department of Cardiology, 'Hippokration' Hospital, Medical School, National and Kapodistrian University of Athens cHypertension Center, 3rd University Department of Medicine, 'Sotiria' Hospital, Athens, Greece dParis Descartes University, AP-HP, Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France.
authors.forename: Athanase D
authors.initials: AD
authors.lastname: Protogerou
authors.forename: Antonis A
authors.initials: AA
authors.lastname: Argyris
authors.forename: Theodoros G
authors.initials: TG
authors.lastname: Papaioannou
authors.forename: Georgios E
authors.initials: GE
authors.lastname: Kollias
authors.forename: Giorgos D
authors.initials: GD
authors.lastname: Konstantonis
authors.forename: Efthimia
authors.initials: E
authors.lastname: Nasothimiou
authors.forename: Apostolos
authors.initials: A
authors.lastname: Achimastos
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
authors.forename: Michel E
authors.initials: ME
authors.lastname: Safar
authors.forename: Petros P
authors.initials: PP
authors.lastname: Sfikakis
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology; D062186:Arterial Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000295:instrumentation / Q000379:methods; D063177:Pulse Wave Analysis; D013997:Time Factors