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Central vs. brachial blood pressure and pulse pressure amplification for mortality risk prediction in patients undergoing coronary angiography

Arterial hypertension is a significant risk factor for cardiovascular (CV) morbidity and mortality. Although central blood pressure (BP) evaluation is considered the gold standard, the reliability of non-invasive measurements remains unclear. Therefore, we compared the predictive value of invasively...

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Main Authors: Daschner, Clara (Author) , Kleber, Marcus E. (Author) , Ayasse, Niklas (Author) , Stach-Jablonski, Ksenija (Author) , Yücel, Gökhan (Author) , Husain-Syed, Faeq (Author) , Niessner, Alexander (Author) , Krüger, Bernd (Author) , März, Winfried (Author) , Krämer, Bernhard (Author) , Yazdani, Babak (Author)
Format: Article (Journal)
Language:English
Published: May 2025
In: American journal of hypertension
Year: 2025, Volume: 38, Issue: 5, Pages: 272-279
ISSN:1941-7225
DOI:10.1093/ajh/hpae156
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/ajh/hpae156
Verlag, lizenzpflichtig, Volltext: https://academic.oup.com/ajh/article/38/5/272/7928547
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Author Notes:Clara Daschner, Marcus E. Kleber, Niklas Ayasse, Ksenija Stach, Gökhan Yücel, Faeq Husain-Syed, Alexander Niessner, Bernd Krüger, Winfried März, Bernhard K. Krämer, and Babak Yazdani
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Summary:Arterial hypertension is a significant risk factor for cardiovascular (CV) morbidity and mortality. Although central blood pressure (BP) evaluation is considered the gold standard, the reliability of non-invasive measurements remains unclear. Therefore, we compared the predictive value of invasively measured central BP with non-invasively measured brachial BP and analyzed pulse pressure (PP) amplification (delta-PP; the difference between central and peripheral PP) as an independent predictor of mortality.We analyzed systolic BP (SBP), diastolic BP (DBP), mean arterial BP (MAP), PP, and delta-PP as predictors of CV and all-cause mortality in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, involving 3,316 patients referred for coronary angiography.All brachial BP parameters, except DBP, were significantly linked to all-cause and CV mortality in a univariate analysis. A 10 mm Hg increase in SBP, MAP, and PP corresponded to increased risks of all-cause (11%, 10%, and 19%) and CV mortality (11%, 11%, and 18%). Central SBP and PP showed similar, but numerically weaker, associations with increased risks of all-cause (5% and 10%) and CV mortality (4% and 8%). After adjusting for age, sex, body mass index, diabetes mellitus, and eGFR, only delta-PP independently predicted mortality with a 10 mm Hg increase linked to a 4% reduction in all causes and a 6% reduction in CV mortality.Neither brachial nor centrally measured BP parameters were independent mortality predictors in contrast to PP amplification, which remained an independent predictor of mortality in multivariate analysis, in a cohort with a medium to high CV risk profile. As PP amplification decreased, mortality increased.
Item Description:Online veröffentlicht: 19. Dezember 2024
Gesehen am 11.06.2025
Physical Description:Online Resource
ISSN:1941-7225
DOI:10.1093/ajh/hpae156

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