Abstract
RuFei Liu, WenLi Cheng(Email:chengwenli2000@163.com) Objective: IAD ≧ 10mmHg has been proven to be a predictor of cardiovascular morbidity and mortality, especially in people with hypertension. Compared with brachial blood pressure, central blood pressure was more effective in reflecting hemodynamic changes and had a stronger relationship with target organ damage. No study has analyzed the degree of central blood pressure in hypertensive patients with IAD < 10mmHg versus ≧ 10mmHg. The objective of this study was to analyze differences in central and brachial arterial blood pressure and the proportion of brachial systolic blood pressure ≧ 140mmHg or central systolic blood pressure ≧ 130mmHg in hypertensive patients grouped by IAD. Methods: The study cohort comprised of 2103 eligible individuals. Their BPs were assessed simultaneously in both arms using an Omron BP-203RPEIII vascular profiler, and the IAD was measured as the absolute difference in these values (absolute value of left minus right). The CBP was noninvasively measured using an Omron HEM-9000AI device. Multivariate regression analysis was used to assess the association between the central SBP (cSBP) and the inter-arm systolic blood pressure difference (IASBPD). Results: Applying 130/140 mmHg as cSBP/bSBP thresholds delineated concordant central and brachial normotension (n = 1131;53.8%) and hypertension (n = 702;33.4%) versus isolated brachial hypertension (n = 178;8.5%) and isolated central hypertension (n = 92;4.4%). Women made up close to 70% of the patient with central systolic hypertension but normal bSBP. After adjusting for brachial SBP, brachial DBP, sex, age and BMI, patients with IAD ≧ 10mmHg had a higher risk of cSBP ≧ 130mmHg [OR (95%CI): 1.6 (1.3, 2.1), P < 0.001]. Conclusion: Hypertensive patients with IAD *&ge* 10mmHg had higher cSBP, cDBP and a higher proportion of central systolic blood pressure.
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