Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality?

@article{Wang2009CentralOP,
  title={Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality?},
  author={Kang-ling Wang and Hao-Min Cheng and Shao-Yuan Chuang and Harold A. Spurgeon and Chih-Tai Ting and Edward G. Lakatta and Frank C. P. Yin and Pesus Chou and Chen-Huan Chen},
  journal={Journal of Hypertension},
  year={2009},
  volume={27},
  pages={461–467}
}
Objective To examine the relationship between brachial and central carotid pressures and target organ indices at baseline and their association with future mortality. Methods We examined, cross-sectionally and longitudinally, the relations of baseline systolic and pulse pressures in central (calibrated tonometric carotid pulse) and peripheral (brachial, mercury sphygmomanometer) arteries to baseline left ventricular mass, carotid intima-media thickness, estimated glomerular filtration rate, and… Expand
Central blood pressure reflects left ventricular load, while brachial blood pressure reflects arterial damage
TLDR
Brachial systolic blood pressure is more closely associated with left ventricular load than brachial blood pressure, while brachIAL blood Pressure is more strongly associated with vascular damage than central blood pressure. Expand
Relations of central and brachial blood pressure to left ventricular hypertrophy and geometry: the Strong Heart Study
TLDR
Left ventricular hypertrophy is more strongly related to systolic pressure than to pulse pressure, and central pressures are more stronglyrelated than brachial pressures to concentric left ventricular geometry, which suggest that absolute (systolic) pressure is more important in stimulatingleft ventricularhypertrophy and remodeling, whereas pulsatile stress (pulse pressure) is moreImportant in causing vascular hyperTrophy and atherosclerosis. Expand
Relation of blood pressure and organ damage: comparison between feasible, noninvasive central hemodynamic measures and conventional brachial measures
TLDR
The findings suggest that central SBP and PP measured with a stand-alone noninvasive BP monitor do not improve diagnostic accuracy for end-organ damage over corresponding brachial measures. Expand
Association of Haemodynamic Indices of Central and Peripheral Pressure with Subclinical Target Organ Damage
Background: Central aortic pressure has often been shown to be more closely associated with markers of vascular function and incidence of cardiovascular events compared to peripheral pressure.Expand
Relationship of central and peripheral blood pressure to left ventricular mass in hypertensive patients.
TLDR
In the population of untreated middle-aged hypertensive patients, left ventricular mass index is more closely related to 24-h ambulatory blood pressure than to office or central blood pressure. Expand
Relations of Central Hemodynamics and Aortic Stiffness with Left Ventricular Structure and Function: The Framingham Heart Study
TLDR
Pulsatile and steady components of central pressure are conjointly yet variably related toLV structure and CFPWV is related to LV diastolic function but not to systolic function. Expand
Relationship of Central and Peripheral Blood Pressure to Left Ventricular Mass in Hypertensive Patients
TLDR
In the population of untreated middle-aged hypertensive patients, left ventricular mass index is more closely related to 24-h ambulatory blood pressure than to office or central blood pressure. Expand
Central Aortic Systolic Blood Pressure Exhibits Advantages Over Brachial Blood Pressure Measurements in Chronic Kidney Disease Risk Prediction in Women
TLDR
CSBP and brachial blood pressure measurements are all predictors of CKD, however the non-invasively obtained CSBP may offer advantages overBrachialBlood pressure measurements in CKD risk prediction in women. Expand
Relationship between 24 h ambulatory central blood pressure and left ventricular mass – Rationale and design of a prospective multicenter study
TLDR
The relationship between central ambulatory blood pressure monitoring and hypertensive end-organ damage (left ventricular mass) in untreated adults is investigated for the first time. Expand
The comparison of the impact of arterial stiffness and central pressure on left ventricular geometry and diastolic function
TLDR
In subjects without documented cardiovascular disease, CSBP and CPP may be more strongly associated with LV diastolic function than baPWV, and further studies with a larger sample size are needed to confirm the results. Expand
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References

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Central Pressure More Strongly Relates to Vascular Disease and Outcome Than Does Brachial Pressure: The Strong Heart Study
TLDR
Noninvasively-determined central pulse pressure is more strongly related to vascular hypertrophy, extent of atherosclerosis, and cardiovascular events than is brachial blood pressure, and these findings support prospective examination of use of central blood pressure as a treatment target in future trials. Expand
Association between local pulse pressure, mean blood pressure, and large-artery remodeling.
TLDR
Carotid pulse pressure was a strong independent determinant of carotid artery enlargement and wall thickening, whereas mean blood pressure and brachial pulse pressure were not, indicating the prominent influence of local pulsatile mechanical load on arterial remodeling. Expand
Cross-Sectional Relations of Peripheral Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness: The Framingham Heart Study
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The findings indicate that abnormal aortic stiffness and increased pressure pulsatility are associated with blunted microvascular reactivity to ischemic stress that is in excess of changes attributable to conventional cardiovascular disease risk factors alone, including mean arterial pressure. Expand
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Additional characterization of volume load and contractile efficiency improves hemodynamic prediction of LV mass, with a further increase in R(2) to .51 when demographic variables are also considered, however, nearly half of the ventricular mass variability remains unexplained. Expand
Brachial Blood Pressure But Not Carotid Arterial Waveforms Predict Cardiovascular Events in Elderly Female Hypertensives
TLDR
The present study determined the relative predictive value for cardiovascular disease–free survival of large artery properties as compared with noninvasive brachial blood pressure alone in a population of elderly female hypertensive subjects and found blood pressure measurement alone is superior to measurement of arterial waveforms in predicting outcome in this group. Expand
Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure: An Evaluation of Their Joint Effect on Mortality
TLDR
This careful analysis from a large cohort study confirmed linear relationships between increasing systolic blood pressure and increasing risk for death and, depending on age, either hockey stickshaped or J-shaped relationships between diastolicBlood pressure and mortality. Expand
Systolic and Diastolic Blood Pressure, Pulse Pressure, and Mean Arterial Pressure as Predictors of Cardiovascular Disease Risk in Men
TLDR
It is suggested that average SBP, diastolic blood pressure, DBP, and MAP strongly predict CVD among younger men, whereas either average SBp or PP predictsCVD among older men. Expand
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TLDR
The present review aims to provide an insight into the (patho)physiology of central blood pressures, to present the most accurate techniques for their estimation, and to discuss the available experimental and epidemiological data that support the emerging need for the evaluation of centralBlood pressures in clinical practice. Expand
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TLDR
It is concluded that for a given ejection pattern (aortic flow), 2 arterial parameters, total arterial resistance andtotal arterial compliance, are sufficient to accurately describe systolic and diastolic aortic pressure. Expand
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TLDR
The regression of carotid artery wall hypertrophy during long-term antihypertensive treatment was dependent on the reduction in local PP rather than on the lowering of mean BP, and the effect of PP lowering on IMT reduction was observed at the site of an elastic artery but not at the sites of a muscular artery. Expand
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