Central Systolic Blood Pressure and Left Ventricular Mass: Findings From the International 24-Hour Aortic Blood Pressure Consortium.
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Danninger Kathrin, Athanasopoulou Elpida, Agharazii Mohsen, Argyris Antonios A, Aoun Bahous Sola, Banegas Jose R, Binder Ronald K, Blacher Jacques, Brandao Andrea A, Brandt Matthias C, de la Sierra Alejandro, Gkaliagkousi Eugenia, Giannattasio Cristina, Hametner Bernhard, Jankowski Piotr, Kollias Anastasios, Li Yan, Maloberti Alessandro, Mayer Christopher C, McDonnell Barry J, McEniery Carmel M, Karachalias Fotis, Mota Gomes Antonio, Muiesan Maria L, Nemcsik Janos, Paiva Annelise M G, Piskorz Daniel, Pucci Giacomo, Rodilla Enrique, Sfikakis Petros P, Stergiou George S, Terentes-Printzios Dimitrios, Vlachopoulos Charalambos, Wilkinson Ian, Protogerou Athanase D, Sharman James E, Wassertheurer Siegfried, Weber Thomas
Аннотация
METHODS: We analyzed data from 21 centers worldwide (n=2367; 45.5% women; mean age 49.5 years) participating in the International 24-Hour Aortic Blood Pressure Consortium. Brachial and central 24-hour SBPs were recorded using the Mobil-O-Graph device, calibrated by either systolic/diastolic (cSBP C1) or mean/diastolic (cSBP C2) pressure; LVMi was derived echocardiographically. BP phenotypes (normotension, isolated diastolic and systolic hypertension, and systolic-diastolic hypertension) were based on 24-hour brachial BPs, subdivided by cSBP.
RESULTS: LVMi correlated most strongly with 24-hour cSBP C2 (P<0.001) consistently, across sex, body mass index (BMI), age, and treatment strata. Receiver operating characteristic analysis showed superior prediction of LV hypertrophy for 24-hour cSBP C2 (area under the curve=0.68). Both brachial BP phenotype and central SBP status were independently associated with LVMi (P=0.0045 and <0.001, respectively), without interaction. Discordant classification occurred in 14.4% of participants and was linked to higher LVMi in normotension and lower LVMi in systolic-diastolic hypertension.
CONCLUSIONS: Twenty-four-hour central SBP calibrated with oscillometric mean/diastolic pressure (cSBP C2), is more closely associated with LVMi and LV hypertrophy than brachial SBP. These findings highlight the potential clinical value of incorporating central pressure monitoring into risk assessment and hypertension management.