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Cardiovascular End Points and Mortality Are Not Closer Associated With Central Than Peripheral Pulsatile Blood Pressure Components
QF. Huang, LS. Aparicio, L. Thijs, FF. Wei, JD. Melgarejo, YB. Cheng, CS. Sheng, WY. Yang, N. Gilis-Malinowska, J. Boggia, TJ. Niiranen, W. Wojciechowska, K. Stolarz-Skrzypek, J. Barochiner, D. Ackermann, V. Tikhonoff, B. Ponte, M. Pruijm, E....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
NLK
Free Medical Journals
od 1979 do Před 1 rokem
Open Access Digital Library
od 1979-01-01
Open Access Digital Library
od 1979-01-01
- MeSH
- dospělí MeSH
- hypertenze mortalita patofyziologie MeSH
- kardiovaskulární nemoci mortalita patofyziologie MeSH
- krevní tlak fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření krevního tlaku MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Pulsatile blood pressure (BP) confers cardiovascular risk. Whether associations of cardiovascular end points are tighter for central systolic BP (cSBP) than peripheral systolic BP (pSBP) or central pulse pressure (cPP) than peripheral pulse pressure (pPP) is uncertain. Among 5608 participants (54.1% women; mean age, 54.2 years) enrolled in nine studies, median follow-up was 4.1 years. cSBP and cPP, estimated tonometrically from the radial waveform, averaged 123.7 and 42.5 mm Hg, and pSBP and pPP 134.1 and 53.9 mm Hg. The primary composite cardiovascular end point occurred in 255 participants (4.5%). Across fourths of the cPP distribution, rates increased exponentially (4.1, 5.0, 7.3, and 22.0 per 1000 person-years) with comparable estimates for cSBP, pSBP, and pPP. The multivariable-adjusted hazard ratios, expressing the risk per 1-SD increment in BP, were 1.50 (95% CI, 1.33-1.70) for cSBP, 1.36 (95% CI, 1.19-1.54) for cPP, 1.49 (95% CI, 1.33-1.67) for pSBP, and 1.34 (95% CI, 1.19-1.51) for pPP (P<0.001). Further adjustment of cSBP and cPP, respectively, for pSBP and pPP, and vice versa, removed the significance of all hazard ratios. Adding cSBP, cPP, pSBP, pPP to a base model including covariables increased the model fit (P<0.001) with generalized R2 increments ranging from 0.37% to 0.74% but adding a second BP to a model including already one did not. Analyses of the secondary end points, including total mortality (204 deaths), coronary end points (109) and strokes (89), and various sensitivity analyses produced consistent results. In conclusion, associations of the primary and secondary end points with SBP and pulse pressure were not stronger if BP was measured centrally compared with peripherally.
Center for Primary Care and Public Health Unisanté University of Lausanne Switzerland
Department of Cardiology Shanghai General Hospital
Department of Medicine Turku University Hospital and University of Turku Finland
Department of Medicine University of Padua Italy
Department of Pharmacology and Cardiovascular Research Institute Maastricht
Division of Nephrology University Hospital of Geneva Geneva Switzerland
Faculty of Medicine Charles University Pilsen Czech Republic
Hypertension Unit Department of Hypertension and Diabetology Medical University of Gdańsk Poland
NPA Alliance for the Promotion of Preventive Medicine Mechelen Belgium
Servicio de Clínica Médica Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Argentina
Citace poskytuje Crossref.org
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- $a Huang, Qi-Fang $u From the Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital (Q.-F.H., Y.-B.C., C.-S.S., J.-G.W., Y.L.)
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- $a Cardiovascular End Points and Mortality Are Not Closer Associated With Central Than Peripheral Pulsatile Blood Pressure Components / $c QF. Huang, LS. Aparicio, L. Thijs, FF. Wei, JD. Melgarejo, YB. Cheng, CS. Sheng, WY. Yang, N. Gilis-Malinowska, J. Boggia, TJ. Niiranen, W. Wojciechowska, K. Stolarz-Skrzypek, J. Barochiner, D. Ackermann, V. Tikhonoff, B. Ponte, M. Pruijm, E. Casiglia, K. Narkiewicz, J. Filipovský, D. Czarnecka, K. Kawecka-Jaszcz, AM. Jula, M. Bochud, T. Vanassche, P. Verhamme, HAJ. Struijker-Boudier, JG. Wang, ZY. Zhang, Y. Li, JA. Staessen, IDCARS (International Database of Central Arterial Properties for Risk Stratification) Investigators
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- $a Pulsatile blood pressure (BP) confers cardiovascular risk. Whether associations of cardiovascular end points are tighter for central systolic BP (cSBP) than peripheral systolic BP (pSBP) or central pulse pressure (cPP) than peripheral pulse pressure (pPP) is uncertain. Among 5608 participants (54.1% women; mean age, 54.2 years) enrolled in nine studies, median follow-up was 4.1 years. cSBP and cPP, estimated tonometrically from the radial waveform, averaged 123.7 and 42.5 mm Hg, and pSBP and pPP 134.1 and 53.9 mm Hg. The primary composite cardiovascular end point occurred in 255 participants (4.5%). Across fourths of the cPP distribution, rates increased exponentially (4.1, 5.0, 7.3, and 22.0 per 1000 person-years) with comparable estimates for cSBP, pSBP, and pPP. The multivariable-adjusted hazard ratios, expressing the risk per 1-SD increment in BP, were 1.50 (95% CI, 1.33-1.70) for cSBP, 1.36 (95% CI, 1.19-1.54) for cPP, 1.49 (95% CI, 1.33-1.67) for pSBP, and 1.34 (95% CI, 1.19-1.51) for pPP (P<0.001). Further adjustment of cSBP and cPP, respectively, for pSBP and pPP, and vice versa, removed the significance of all hazard ratios. Adding cSBP, cPP, pSBP, pPP to a base model including covariables increased the model fit (P<0.001) with generalized R2 increments ranging from 0.37% to 0.74% but adding a second BP to a model including already one did not. Analyses of the secondary end points, including total mortality (204 deaths), coronary end points (109) and strokes (89), and various sensitivity analyses produced consistent results. In conclusion, associations of the primary and secondary end points with SBP and pulse pressure were not stronger if BP was measured centrally compared with peripherally.
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