Central blood pressure obtained by cuff-based oscillometry as a determinant of left ventricular hypertrophy in hypertensive patients.

IF 1.2 4区医学 Q4 PERIPHERAL VASCULAR DISEASE Blood Pressure Monitoring Pub Date : 2023-12-01 Epub Date: 2023-08-14 DOI:10.1097/MBP.0000000000000669

Mohamed Aboel-Kassem F Abdelmegid, Doaa A Fouad, Nardeen W M Beshay, Dalia G Mahran, Hamdy Shams-Eddin

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Abstract

Objective: Limited and conflicting data have been reported on the prognostic relevance of central blood pressure (CBP) compared with brachial blood pressure (BP) in the anticipation of hypertension-mediated organ damage and the majority of data derived using applanation tonometry with its known complexities. The objective of the present study was to investigate the diagnostic factors of left ventricular hypertrophy (LVH) with a special highlight on the utility of non-invasive oscillometric CBP measurement and derived hemodynamic indices compared to brachial BP as indicators of LVH.

Methods: This cross-sectional study included 300 hypertensive patients (mean age 55.3 years, 61.3% female, 51.7% obese) with a mean duration of hypertension was 5.8 years. They underwent measurement of brachial BP, using a mercury sphygmomanometer, and CBP, using a Mobil-O-Graph, alongside the determination of left ventricular (LV) mass by two-dimensional transthoracic echocardiography. LVH and LV geometric patterns were defined by LV mass index/height 2.7 and relative wall thickness.

Results: Bivariate then multivariate analysis showed that age, BMI, central systolic BP (SBP), and pulse wave velocity (PWV) were significant determinants of LVH and optimally controlled brachial BP was a significant negative determinant for LVH. Central SBP had an acceptable diagnostic performance to determine LVH in patients with hypertension (AUC = 0.722, 95% confidence interval: 0.618-0.824, SE = 0.21, P -value <0.001). Using one-way ANOVA, a comparison of means among age groups showed that the steady increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients.

Conclusion: Estimated central SBP using Mobil-O-Graph showed a significantly higher correlation to LVH than brachial SBP values. The consistent increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients.

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通过基于袖带的示波法获得的中心血压作为高血压患者左心室肥大的决定因素。

目的：关于中枢血压（CBP）与肱动脉血压（BP）在预测高血压介导的器官损伤中的预后相关性，已经报道了有限且相互矛盾的数据，并且大多数数据是使用具有已知复杂性的压平眼压计得出的。本研究的目的是研究左心室肥大（LVH）的诊断因素，特别强调非侵入性示波CBP测量的实用性，以及与肱动脉血压相比得出的血液动力学指标作为LVH的指标。方法：这项横断面研究包括300名高血压患者（平均年龄55.3岁，女性61.3%，肥胖51.7%），平均高血压持续时间5.8年。他们使用水银血压计测量了肱动脉血压，并使用Mobil-O-Graph测量了CBP，同时通过二维经胸超声心动图测定了左心室（LV）质量。LVH和LV几何图形由LV质量指数/高度2.7和相对壁厚定义。结果：双变量后多变量分析显示，年龄、BMI、收缩压（SBP）和脉搏波速度（PWV）是LVH的显著决定因素，最佳控制的肱动脉压是LVH显著的负决定因素。中枢SBP在确定高血压患者LVH方面具有可接受的诊断性能（AUC = 0.722，95%置信区间：0.618-0.824，SE = 0.21，P值结论：使用Mobil-O-Graph估计的中心收缩压与LVH的相关性明显高于肱动脉收缩压值。LVH患者的中心收缩压和PWV随年龄的持续增加大于非LVH患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Pressure Monitoring 医学-外周血管病

CiteScore

2.00

自引率

7.70%

发文量

110

审稿时长

>12 weeks

期刊介绍： Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.