Abstract
BackgroundBoth ambulatory blood pressure (AMBP) and non-invasive central blood pressure (NCBP) monitoring could be used as predictors for early detection of hypertensive end organ damage (EOD). However, the comparison between these two methods needs more clarification. Our cross-sectional study included 100 hypertensive patients with a mean age of 47.52 ± 8.35 years on regular antihypertensive treatment for ≥ 1 year (50 controlled, 50 uncontrolled). We compared associations, sensitivity, and specificity of EOD parameters with office, AMBP, and NCBP measurements. We measured left ventricular mass index (LVMI), carotid intimal medial thickness (CIMT), ankle-brachial index (ABI), serum creatinine, glomerular filtration rate (GFR), and pulse wave velocity (PWV).ResultsWe found a significant relation between SBP of NCBP, AMBP and LVMI, and CIMT, PWV, and GFR respectively (P < 0.05) while office SBP showed no significant relation. Systolic AMBP showed a high sensitivity to ABI (98%) and CIMT (92%) while systolic NCBP had 92% specificity and DBP showed 90% sensitivity for ABI.ConclusionAMBP and NCBP show a significant relation to LVMI, CIMT, PWV, and GFR with little superiority of central BP while office BP does not. Systolic ABPM has high sensitivity to ABI and CIMT and systolic NCBP has a high sensitivity and specificity to ABI.
Highlights
Both ambulatory blood pressure (AMBP) and non-invasive central blood pressure (NCBP) monitoring could be used as predictors for early detection of hypertensive end organ damage (EOD)
Patients were divided into two groups, either controlled or uncontrolled office BP according to the European Society of Cardiology (ESC) guidelines 2013 (≥ 140 mmHg systolic BP (SBP) and/or ≥ 90 mmHg diastolic BP (DBP)
In our study, we found that 24 h ambulatory BP monitoring (ABPM) and non-invasive central BP monitoring are good predictable measures for early detection of hypertensive end organ damage
Summary
Both ambulatory blood pressure (AMBP) and non-invasive central blood pressure (NCBP) monitoring could be used as predictors for early detection of hypertensive end organ damage (EOD). Reliability of brachial blood pressure (BP) measurement in the physician’s office has its own limitations, while out-of-office BP measurement, using either home BP monitoring or ambulatory BP monitoring (ABPM) techniques, is devoid of such limitations and is gaining importance in the management of hypertension. When brachial artery blood pressure was used to stratify blood pressure measurements, a considerable overlap in aortic systolic pressure was observed, such that over 70% of individuals were categorized as having “high-normal” brachial systolic pressure based on Joint European Cardiology and Hypertension Society guidelines [4], and. The Dicomano Study in Italy [6] and a Taiwanese study [7] observed a stronger association between cardiovascular events and central, rather than brachial pressure. Evidence published over the last 12 years is concerning the relationship between central pressures [8]
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