Abstract
Abstract Background Controversy exists in the comparison between central and peripheral blood pressure (BP) in predicting the future cardiovascular risk. Aim To examine whether central BP predicts cardiovascular events and mortality better than brachial BP in a large cohort of elderly Chinese. Method A total of 3048 participants enrolled in the Northern Shanghai Study, a prospective cohort study focusing on the cardiovascular risk of community-dwelling elderly Chinese living in the north of Shanghai, China between 2014 and 2019, were included. Central BP was estimated tonometrically from the redial pulse waveform. The vital status and cardiovascular events of all participants were confirmed by reviewing the regional morality record system in October 2022. Cox proportional hazards models were conducted to evaluated the predictive value of central and peripheral systolic BP (SBP) and pulse pressure (PP). Results During the median follow-up of 5.6 years, the primary composite cardiovascular endpoint was occurred in 315 participants (10.3%). When central and peripheral SBP were analyzed separately, both central and peripheral SBP significantly associated with the primary composite endpoint (Peripheral: HR 1.047, 95% CI 1.016 to 1.079; Central: HR 1.051, 95%CI 1.020 to 1.091; Per 5 mm Hg), after adjusting age, sex, BMI, current smoking, lipid, cerebrocardiovascular disease, diabetes, antihypertensive treatment, statin treatment, hypoglycemic treatment and estimated glomerular filtration rate. When central and peripheral SBP were included in the same stepwise Cox regression, only central SBP stayed in the final model (HR 1.054, 95%CI 1.024 to 1.085, per 5 mm Hg), after adjustment for covariates. Similar trends were observed on the comparison between central and peripheral PP. Conclusions Central BP predicts the future cardiovascular risk better than peripheral BP in the elderly Chinese.
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