THE PREDICTION OF CARDIOVASCULAR EVENTS BY PHENOTYPE OF CENTRAL AND PERIPHERAL BLOOD PRESSURE IN SUBJECTS WITHOUT HYPERTENSION

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Objective: Hypertension (HBP) is a common disease with aging, but the rate of recognition or poor control is still high. Until now, most guidelines related to HBP consisted of only peripheral blood pressure (BP) measurement. However, according to many studies, it is known that central BP (CBP) has a clearer relationship than peripheral BP, which can more clearly express an individual's BP status with the prediction of cardiovascular (CV) events. Therefore, we aimed to evaluate the effect of CBP on the prediction of CV events and to investigate the prediction of CV events by phenotype of central and peripheral BP in subjects without hypertension. Design and method: A total of 2910 patients were enrolled from June 2011 to December 2016, and were followed up through October 2022. CBP was measured using radial tonometry. The primary endpoints were composite outcome. Results: The median follow-up period for enrolled patients was 7.5 years. Out of a total of 722 patients (mean age of 52.5 ± 13.7 years) without HBP, 21 patients (2.9%) had events of primary end points during the follow up period. Systolic BP averaged 126 mmHg (±15 mmHg) in the event-free group and 136 mmHg (±15 mmHg) in the CV event group, while CBP measured 115 mmHg (±16 mmHg) in the event-free group and 126 mmHg (±16 mmHg) in the CV event group. In Cox proportional hazards model, CBP and systolic BP, every 10 mmHg increase, showed an increase in risk of 30% and 40% respectively. Isolated central systolic hypertension and both central and peripheral systolic hypertension showed 4.9 % and 6% of the CV event rate, respectively (p = 0.897). Conclusions: Irrespective of the brachial BP status, isolated central hypertension increased CV events. Therefore, to prevent CV events is an essential control not peripheral BP but also CBP.