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Association of central and peripheral pulse pressure with intermediate cardiovascular phenoytpes.

Neisius, Ulf; Bilo, Grzegorz; Taurino, Chiara; McClure, John D; Schneider, Markus P; Kawecka-Jaszcz, Kalina; Stolarz-Skrzypek, Katarzyna; Klima, Lukasz; Staessen, Jan A and Kuznetsova, Tatiana, et al. (2012) In Journal of Hypertension 30(1). p.67-74
Abstract
OBJECTIVE: We assessed the relationship between pulse pressure and intermediate cardiovascular phenotypes in a middle-aged cohort with high prevalence of hypertension. BACKGROUND: It has been suggested that central pulse pressure (cPP) is a better predictor of cardiovascular outcome than peripheral pulse pressure (pPP), particularly in the elderly. Yet, it is unclear if cPP provides additional prognostic information to pPP in younger individuals. METHODS: In 535 individuals we assessed cPP and pPP as well as the intermediate cardiovascular phenotypes pulse wave velocity (PWV; SphygmoCor, Complior, PulsePen), carotid intima-media thickness (C-IMT; carotid ultrasound), left-ventricular mass index (LVMI; echocardiography) and urinary albumin... (More)
OBJECTIVE: We assessed the relationship between pulse pressure and intermediate cardiovascular phenotypes in a middle-aged cohort with high prevalence of hypertension. BACKGROUND: It has been suggested that central pulse pressure (cPP) is a better predictor of cardiovascular outcome than peripheral pulse pressure (pPP), particularly in the elderly. Yet, it is unclear if cPP provides additional prognostic information to pPP in younger individuals. METHODS: In 535 individuals we assessed cPP and pPP as well as the intermediate cardiovascular phenotypes pulse wave velocity (PWV; SphygmoCor, Complior, PulsePen), carotid intima-media thickness (C-IMT; carotid ultrasound), left-ventricular mass index (LVMI; echocardiography) and urinary albumin : creatinine ratio (ACR). cPP was derived noninvasively from brachial blood pressure by pulse wave analysis (PWA; SphygmoCor) based on radial pulse wave tonometry and a validated transfer function. RESULTS: The cohort contained 331 hypertensive participants of whom 84% were treated. The average age was 46 ± 16 years. When compared to pPP, cPP had stronger associations with PWV (r = 0.471 vs. r = 0.372; P < 0.01), C-IMT (r = 0.426 vs. r = 0.235; P < 0.01) and LVMI (r = 0.385 vs. r = 0.189; P < 0.01), but equal association with ACR (r = 0.236 vs. r = 0.226; P = n.s.). In contrast, after adjustment for age, mean arterial pressure, heart rate and hypertension status there was no significant difference between cPP and pPP for prediction of PWV (adjusted R, 0.399 vs. 0.413; P = 0.066), C-IMT (adjusted R, 0.399 vs. 0.413; P = 0.487) and LVMI (adjusted R, 0.181 vs. 0.170; P = 0.094) in multivariate analysis. CONCLUSION: In our middle-aged cohort with high prevalence of hypertension cPP is more closely correlated with cardiovascular phenotypes than pPP. When adjusted for relevant cofactors, however, cPP does not provide additional information beyond pPP. (Less)
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Contribution to journal
publication status
published
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Journal of Hypertension
volume
30
issue
1
pages
67 - 74
publisher
Lippincott Williams & Wilkins
external identifiers
  • WOS:000298153700013
  • PMID:22134387
  • Scopus:83555166286
ISSN
1473-5598
DOI
10.1097/HJH.0b013e32834e12d8
language
English
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yes
id
1e4df6ad-7345-4138-8d40-753af6da99e5 (old id 2274671)
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http://www.ncbi.nlm.nih.gov/pubmed/22134387?dopt=Abstract
date added to LUP
2012-01-02 12:41:45
date last changed
2016-10-13 04:23:49
@misc{1e4df6ad-7345-4138-8d40-753af6da99e5,
  abstract     = {OBJECTIVE: We assessed the relationship between pulse pressure and intermediate cardiovascular phenotypes in a middle-aged cohort with high prevalence of hypertension. BACKGROUND: It has been suggested that central pulse pressure (cPP) is a better predictor of cardiovascular outcome than peripheral pulse pressure (pPP), particularly in the elderly. Yet, it is unclear if cPP provides additional prognostic information to pPP in younger individuals. METHODS: In 535 individuals we assessed cPP and pPP as well as the intermediate cardiovascular phenotypes pulse wave velocity (PWV; SphygmoCor, Complior, PulsePen), carotid intima-media thickness (C-IMT; carotid ultrasound), left-ventricular mass index (LVMI; echocardiography) and urinary albumin : creatinine ratio (ACR). cPP was derived noninvasively from brachial blood pressure by pulse wave analysis (PWA; SphygmoCor) based on radial pulse wave tonometry and a validated transfer function. RESULTS: The cohort contained 331 hypertensive participants of whom 84% were treated. The average age was 46 ± 16 years. When compared to pPP, cPP had stronger associations with PWV (r = 0.471 vs. r = 0.372; P &lt; 0.01), C-IMT (r = 0.426 vs. r = 0.235; P &lt; 0.01) and LVMI (r = 0.385 vs. r = 0.189; P &lt; 0.01), but equal association with ACR (r = 0.236 vs. r = 0.226; P = n.s.). In contrast, after adjustment for age, mean arterial pressure, heart rate and hypertension status there was no significant difference between cPP and pPP for prediction of PWV (adjusted R, 0.399 vs. 0.413; P = 0.066), C-IMT (adjusted R, 0.399 vs. 0.413; P = 0.487) and LVMI (adjusted R, 0.181 vs. 0.170; P = 0.094) in multivariate analysis. CONCLUSION: In our middle-aged cohort with high prevalence of hypertension cPP is more closely correlated with cardiovascular phenotypes than pPP. When adjusted for relevant cofactors, however, cPP does not provide additional information beyond pPP.},
  author       = {Neisius, Ulf and Bilo, Grzegorz and Taurino, Chiara and McClure, John D and Schneider, Markus P and Kawecka-Jaszcz, Kalina and Stolarz-Skrzypek, Katarzyna and Klima, Lukasz and Staessen, Jan A and Kuznetsova, Tatiana and Redon, Josep and Martinez, Fernando and Rosei, Enrico Agabiti and Muiesan, Maria L and Melander, Olle and Zannad, Faiez and Rossignol, Patrick and Laurent, Stéphane and Collin, Cedric and Lonati, Laura and Zanchetti, Alberto and Dominiczak, Anna F and Delles, Christian},
  issn         = {1473-5598},
  language     = {eng},
  number       = {1},
  pages        = {67--74},
  publisher    = {ARRAY(0x73f0a80)},
  series       = {Journal of Hypertension},
  title        = {Association of central and peripheral pulse pressure with intermediate cardiovascular phenoytpes.},
  url          = {http://dx.doi.org/10.1097/HJH.0b013e32834e12d8},
  volume       = {30},
  year         = {2012},
}