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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| Hauptverfasser: | , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
May 2025
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| In: |
American journal of hypertension
Year: 2025, Jahrgang: 38, Heft: 5, Pages: 272-279 |
| ISSN: | 1941-7225 |
| DOI: | 10.1093/ajh/hpae156 |
| Online-Zugang: | 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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| Verfasserangaben: | 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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| 520 | |a 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. | ||
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