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SHR Neuro Cancer Cardio Lipid Metab Microb
Daschner, C; Kleber, ME; Ayasse, N; Stach, K; Yücel, G; Husain-Syed, F; Niessner, A; Krüger, B; März, W; Krämer, BK; Yazdani, B.
Central vs. Brachial Blood Pressure and Pulse Pressure Amplification for Mortality Risk Prediction in Patients Undergoing Coronary Angiography.
Am J Hypertens. 2024;
Doi: 10.1093/ajh/hpae156
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- März Winfried
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- Abstract:
- BACKGROUND: Arterial hypertension is a significant risk factor for cardiovascular (CV) morbidity and mortality. Although central blood pressure (BP) evaluation is considered the gold standard, the reliability of non-invasive measurements remains unclear. Therefore, we compared the predictive value of invasively measured central BP with non-invasively measured brachial BP and analyzed pulse pressure (PP) amplification (delta-PP; difference between central and peripheral PP) as an independent predictor of mortality. METHODS: We analyzed systolic (SBP), diastolic (DBP), mean arterial BP (MAP), PP and delta-PP as predictors of CV and all-cause mortality in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, involving 3316 patients referred for coronary angiography. RESULTS: All brachial BP parameters, except DBP, were significantly linked to all-cause and CV mortality in a univariate analysis. A 10 mmHg increase in SBP, MAP, and PP corresponded to increased risks of all-cause (11%, 10%, and 19%) and CV mortality (11%, 11%, and 18%). Central SBP and PP showed similar, but numerically weaker, associations with increased risks of all-cause (5% and 10%) and CV mortality (4% and 8%).After adjusting for age, sex, BMI, diabetes mellitus, and eGFR, only delta-PP independently predicted mortality with a 10 mmHg increase linked to a 4% reduction in all-cause and 6% reduction in CV mortality. CONCLUSIONS: Neither brachial nor centrally measured BP parameters were independent mortality predictors in contrast to PP amplification, which remained an independent predictor of mortality in multivariate analysis, in a cohort with a medium to high CV risk profile. As PP amplification decreased, mortality increased.
- Find related publications in this database (Keywords)
- arterial hypertension
- arterial stiffness
- blood pressure
- coronary artery disease
- heart failure
- hypertension
- pulse pressure
- pulse pressure amplification