Peripheral Blood Pressure Parameters Research Articles

CARDIOVASCULAR RISK RECLASSIFICATION BY PULSE WAVE VELOCITY IN BRAZILIAN HYPERTENSIVE PATIENTS

Objective: Objetive: The number of asymptomatic hypertensive patients who already have subclinical injuries in the early stages of hypertensive disease is high and, generally, they are not identified by the traditional evaluation model. The use of Pulse Wave Velocity (PWV) in addition to traditional cardiovascular risk factors can improve risk stratification. The present study intends to perform the reclassification of cardiovascular risk according to the median Pulse Wave Velocity (PWV) and correlate PWV with the intima-media thickness, with the left ventricular (LV) mass indexed and with microalbuminuria. Design and method: Design and method: Multicenter analytical cross-sectional study of patients undergoing measurement of central and peripheral blood pressure parameters between October/2018 and March/2019. Intima-media thickness (IMT) and presence of carotid plaque, left ventricular mass indexed and microalbuminuria were also evaluated. Fisher’s test was applied to verify the association of cardiovascular risk reclassification by median PWV. Spearman’s correlation was used to correlate PWV with intima-media thickness, presence or absence of carotid plaque, microalbuminuria and indexed left ventricular mass. A significance level of 5% was adopted. Results: Results: 126 patients were evaluated, with a mean age of 60.58 ± 10.51 years and 87 (69.95%) are women. When reclassified, there was an increase in the frequency of patients who moved from medium to high risk (p<0.001). A weak and positive correlation was identified between PWV and LV mass indexed (r = 0.304, p < 0.001) and with IMT (r = 0.30, p < 0.001). Conclusions: Conclusions: The application of median PWV values is a simple and effective tool to reclassify intermediate-risk individuals to high-risk.

Changes in central and peripheral blood pressure parameters during antiangiogenic treatment of metastatic renal cell carcinoma.

Changes in central and peripheral blood pressure parameters during antiangiogenic treatment of metastatic renal cell carcinoma.

Relationship of coronary collateral development with mean arterial pressure in patients with stable coronary artery disease

Aim: The prognostic value of blood pressure and the association between these parameters and cardiovascular conditions have been established in literature. In this study, we aimed to investigate the correlation between peripheral blood pressure parameters with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical artery stenosis. Methods: A total of 363 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: group with adequate CCD (n=120) and group with inadequate CCD (n=243). Peripheral blood pressure parameters were evaluated before coronary arteriography. Results: Peripheral diastolic blood pressure (DBP) and mean arterial pressure (MAP) levels were significantly higher in the inadequate CCC group (81.5±10.7 vs 77.9±9.9 p=0.02 and 100.6±11.8 vs 96.6±9.3 99,8mmHG, sensitivity and specificity of MAP were 57% and 69%, respectively. At the cut-off value of >79,5 mmHg, sensitivity and specificity of DAP were 72% and 42%, respectively. Conclusion: The present study suggests that Peripheral DBP and MAP levels may be associated with degree of collateral development in chronic stable CAD. Low peripheral DBP and MAP in the case of severe coronary stenosis in stable CAD may be an important stimulus for coronary collateral development.

PS 05-71 CROSS-SECTIONAL RELATIONS OF PERIPHERAL BLOOD PRESSURE AND CENTRAL BLOOD PRESSURE ACCORD TO AGE; DATA FROM THE KOREAN REGISTRY OF TARGET ORGAN DAMAGES IN HYPERTENSION(KorHR)

Objective: To determine the relationship between peripheral blood pressure (BP) parameters and central BP parameters accord to age. Design and Method: The Korean Registry of Target Organ Damages in Hypertension (KorHR) is a multi-centered prospective study which has enrolled 1318 essential hypertension patients without any cardiovascular diseases since March 2013. Among these patients, this study analyzed 417 patients whose central BP data were available. Central and peripheral BP parameters were evaluated in relation to age groups (young: 20–39 yrs, n = 113; middle: 40–59 yrs, n = 292; old: 60 or more yrs, n = 112). Results: Despite similar central systolic BP across the 3 categories (130.1 ± 18.7 vs. 130.5 ± 17 vs. 132.6 ± 17.5, p = 0.614), there were a significant decreasing trend of peripheral systolic BP with age (151.1 ± 21.4 vs. 145.8 ± 18.5 vs. 140.4 ± 21, p = 0.002). In multivariate regression analysis, peripheral systolic BP was an independent determinant of central systolic BP only in the old age category (age≥60 yrs; β = 0.387, p < 0.001). Peripheral diastolic BP was more powerful predictor of central systolic BP compared to peripheral systolic BP in the young (age 20–39 yrs; β = 0.356, p < 0.001) and the middle aged (40–59 yrs; β = 0.219, p < 0.001) patients. Brachial PWV was the only variable which predicted central systolic BP significantly across all the 3 age groups. Conclusions: Peripheral systolic BP could predict central systolic BP only in old aged hypertensive individuals whose PWV was faster than that of younger individuals. These data suggests that peripheral systolic BP might have a limited value for predicting central systolic BP in young and middle aged individuals due to less degree of arterial stiffness compared to old aged individual.

СENTRAL AORTIC PRESSURE AND AUGMENTATION INDEX IN YOUNG ADULTS WITH REGARD TO CARDIOVASCULAR RISK FACTORS

O bjective. To estimate central aortic blood pressure (BP) and index of augmentation in young people, taking into account the presence of risk factors (RF), during preventive medical examination. Desig n an d methods. Altogether 78 students of 3–4 years, aged 19–23 years old have been surveyed within the framework of the regular medical examinations, at the Center of Students’ Health, Stavropol State Medical University, as a part of the project “University is the territory of health”. Besides RF assessment, central aortic pressure was evaluated by oscillometric method (BPLab, “Peter Telegin”,Novosibirsk,Russia; Vasotens Office). In addition to common peripheral BP parameters, this technology provides measurements of systolic BP aortic (SYSао), diastolic BP aortic (DIAао), pulse BP aortic (PPао), average BP aortic (ABPао), left ventricular ejection duration (ED), augmentation index in aorta (AIxао), pulse pressure amplification (PPA) and subendocardial viability ratio (SEVR). Surveyed students were distributed into two groups: first group — without RF (control group), and second group — with RF (main group). For automatic tubulation of all parameters we used the operational system BPStat ® version 05.00.04 (“Petr Telegin”). For statistical data processing program “Statistica8” was used. R esults. At young age RF are associated with the increase of both peripheral and aortic BP, especially systolic and pulse ВР, as well as augmentation index of central ВР. In students RF are associated with the increase of aortic BP (isolated central or masked hypertension/prehypertensionwith the simultaneous increase of both peripheral and aortic BP). The frequency of isolated increase of peripheral BP among students with RF is similar to that in students without RF. C onclusions. Thus, planimetric analysis of central pulse wave in young people allows to define various mechanisms leading to the early BP increase. These data enable differentiated premorbid diagnostics of hemodynamic status in young adults with cardiovascular RF. This approach will contribute to the more individualized preventive measures in young population.

THE RELATIONSHIP BETWEEN CENTRAL AORTIC PRESSURE, BRACHIAL BLOOD PRESSURE AND LEFT VENTRICULAR MASS INDEX: IN FIRST DIAGNOSED HYPERTENSIVE PATIENTS: PP.29.164

Background: Central (aortic) blood pressure (BP) has been reported as a more powerful indicator to predict cardiovascular risk than peripheral (brarchial) BP. Also, increased left ventricular mass index (LVMI) and its change during treatment can predict cardiovascular complications in hypertensive subjects. However, the relationship between aortic or peripheral BP and LVMI is not clear especially in first diagnosed hypertensive subjects. We purposed to compare the relationship of LVMI with central and peripheral BP parameters. Methods: We studied 111 patients who diagnosed hypertension for the first time without any medical history including diabetes (mean age: 47 ± 10 years, 72 males). Subjects with heart failure, any significant valvular disease or cardiomyopathy on echocardiogram were excluded. Peripheral BP was measured by automatic sphygmomanometer at brachial artery and central BP was measured by analysis of non-invasive radial artery pulse wave using automated applanation tonometry. The LVMI was calculated from M-mode echocardiographic data and body surface area. To avoid multiple co-linearity among BP parameters, multiple regressions predicting LVMI were done four times. Results: Baseline central and peripheral systolic BP (SBP) were 136 ± 17 and 150 ± 18mmHg (p < 0.001) and each mean pulse pressure (PP) was 41 ± 11 and 53 ± 13 mmHg respectively (p < 0.001). Mean PP difference was 11.7 ± 12.0 mmHg and mean LVMI was 109 ± 22 g. The LVMI was positively correlated with age, peripheral SBP & PP, central SBP & PP, and carotid intima-media thickeness (r = 0.231, 0.276, 0.283, 0.248, 0.343, 0.259 respectively, each p < 0.05). But, PP difference was not significantly correlated (p = 0.915). Although central and peripheral systolic and pulse pressures were still significantly related to LVMI after adjustment for age in the four different analyses, central PP was stronger predictor than peripheral PP (β coefficient = 0.311, p = 0.001 vs. 0.281, p = 003). Conclusion: Left ventricular mass index, which is one of useful indicators for predict cardiovascular risk and outcome of hypertension, is independently and positively associated with blood pressure parameters. Central pulse pressure is particularly more strongly related with LVMI than peripheral BP parameters.

Pulsatile but Not Steady Component of Blood Pressure Predicts Cardiovascular Events in Coronary Patients

Although the differences between central and peripheral blood pressure (BP) values have been known for decades, the consequences of decision making based on peripheral rather than central BP have only recently been recognized. There are only a few studies assessing the relationship between intraaortic BP and cardiovascular risk. In addition, the relationship between central BP and the risk of cardiovascular events in a large group of coronary patients has not yet been evaluated. Therefore, the aim of the study was to determine the prognostic significance of central BP-derived indices in patients undergoing coronary angiography. Invasive central BPs were taken at baseline, and study end points were ascertained during over a 4.5-year follow-up in 1109 consecutive patients. The primary end point (cardiovascular death or myocardial infarction or stroke or cardiac arrest or heart transplantation or myocardial revascularization) occurred in 246 (22.2%) patients. Central pulsatility was the most powerful predictor of the primary end point (hazard ratio [HR] 1.30, 95% confidence interval [CI] 1.14 to 1.48). Central pulse pressure was also independently related to the primary end point (HR 1.25, 95% CI 1.09 to 1.43). Central mean BP as well as peripheral BP parameters were not independently related to the primary end point risk. Central pulsatility was also related to risk of cardiovascular death or myocardial infarction or stroke. The pulsatile component of BP is the most important factor related to the cardiovascular risk in coronary patients. It is more closely associated with cardiovascular risk than steady component of BP.