title: Association of Central Versus Brachial Blood Pressure With Target-Organ Damage: Systematic Review and Meta-Analysis.
abstract: Accumulating evidence suggests that central blood pressure (BP) may reflect the hemodynamic stress on target organs more accurately than brachial BP. A systematic review assessing the relationship of central versus brachial BP with preclinical target-organ damage was performed. Meta-analysis of cross-sectional data showed that central compared with brachial systolic BP was more closely associated with (1) left ventricular mass index (12 studies, n=6431; weighted age [SD], 49.9 [13.1] years; 51% hypertensives): pooled correlation coefficients r=0.30; 95% confidence interval (CI), 0.23-0.37 versus r=0.26; 95% CI, 0.19-0.33, respectively; P<0.01 for difference; (2) carotid intima-media thickness (7 studies, n=6136; weighted age, 55.6 [13.2] years; 48% hypertensives): r=0.27; 95% CI, 0.19-0.34 versus r=0.23; 95% CI, 0.16-0.30, respectively; P<0.01 for difference; (3) pulse-wave velocity (14 studies, n=3699; weighted age, 53.9 [13.3] years; 53% hypertensives): r=0.42; 95% CI, 0.37-0.47 versus r=0.39; 95% CI, 0.33-0.45, respectively; P<0.01 for difference. Four studies assessing urine albumin excretion (n=3718; weighted age, 56.4 [5] years; 69% hypertensives) reported similar correlations (P=not significant) with central (r=0.22; 95% CI, 0.14-0.29) and brachial systolic BP (r=0.22; 95% CI, 0.12-0.32). Similar findings were observed for central compared with brachial pulse pressure in terms of relationship with target-organ damage. Metaregression analyses did not reveal any significant effect of age. In conclusion, central compared with brachial BP seems to be more strongly associated with most of the investigated indices of preclinical organ damage.
authors.affiliation: From the Third University Department of Medicine, Hypertension Center, STRIDE-7, Sotiria Hospital, Athens, Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Kollias
authors.affiliation: From the Third University Department of Medicine, Hypertension Center, STRIDE-7, Sotiria Hospital, Athens, Greece.
authors.forename: Styliani
authors.initials: S
authors.lastname: Lagou
authors.affiliation: From the Third University Department of Medicine, Hypertension Center, STRIDE-7, Sotiria Hospital, Athens, Greece.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Zeniodi
authors.affiliation: From the Third University Department of Medicine, Hypertension Center, STRIDE-7, Sotiria Hospital, Athens, Greece.
authors.forename: Nadia
authors.initials: N
authors.lastname: Boubouchairopoulou
authors.affiliation: From the Third University Department of Medicine, Hypertension Center, STRIDE-7, Sotiria Hospital, Athens, Greece. gstergi@med.uoa.gr.
authors.forename: George S
authors.initials: GS
authors.lastname: Stergiou
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000503:physiopathology*; D063177:Pulse Wave Analysis; D012307:Risk Factors
keywords: albuminuria; aortic blood pressure; carotid intima-media thickness; left ventricular hypertrophy; meta-analysis; pulse wave velocity