OBJECTIVE: To address to what extent central hemodynamic measurements, improve risk stratification, and determine outcome-based diagnostic thresholds, we constructed the International Database of Central Arterial Properties for Risk Stratification (IDCARS), allowing a participant-level meta-analysis. The purpose of this article was to describe the characteristics of IDCARS participants and to highlight research perspectives. METHODS: Longitudinal or cross-sectional cohort studies with central blood pressure measured with the SphygmoCor devices and software were included. RESULTS: The database included 10,930 subjects (54.8% women; median age 46.0 years) from 13 studies in Europe, Africa, Asia, and South America. The prevalence of office hypertension was 4,446 (40.1%), of which 2,713 (61.0%) were treated, and of diabetes mellitus was 629 (5.8%). The peripheral and central systolic/diastolic blood pressure averaged 129.5/78.7 mm Hg and 118.2/79.7 mm Hg, respectively. Mean aortic pulse wave velocity was 7.3 m per seconds. Among 6,871 participants enrolled in 9 longitudinal studies, the median follow-up was 4.2 years (5th-95th percentile interval, 1.3-12.2 years). During 38,957 person-years of follow-up, 339 participants experienced a composite cardiovascular event and 212 died, 67 of cardiovascular disease. CONCLUSIONS: IDCARS will provide a unique opportunity to investigate hypotheses on central hemodynamic measurements that could not reliably be studied in individual studies. The results of these analyses might inform guidelines and be of help to clinicians involved in the management of patients with suspected or established hypertension.

1st Department of Cardiology Interventional Electrocardiology and Hypertension Jagiellonian University Medical College Kraków Poland

Biomedical Sciences Group Faculty of Medicine University of Leuven Leuven Belgium

Cardiovascular Pathophysiology and Genomics Research Unit Schools of Physiology Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa

Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China

Centro de Nefrología and Departamento de Fisiopatología Hospital de Clínicas Universidad de la República Montevideo Uruguay

Clinic for Nephrology and Hypertension Inselspital Bern University Hospital and University of Bern Bern Switzerland

Department of Cardiology Shanghai General Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

Department of Cardiology the 1st Affiliated Hospital of Sun Yat Sen University Guangzhou Guangdong China

Department of Chronic Disease Prevention Finnish Institute for Health and Welfare Turku Finland

Department of Internal Medicine Faculty of Clinical Sciences College of Health Sciences University of Abuja Abuja Nigeria

Department of Medicine University of Padua Padua Italy

Department of Medicine University of Turku and Turku University Hospital Turku Finland

Faculty of Medicine Charles University Pilsen Czech Republic

Hypertension in Africa Research Team South African Medical Research Council and Unit of Hypertension and Cardiovascular Disease North West University Potchefstroom South Africa

Hypertension Unit Department of Hypertension and Diabetology Medical University of Gdańsk Gdańsk Poland

Institute of Social and Preventive Medicine University Hospital of Lausanne Lausanne Switzerland

Research Institute Alliance for the Promotion of Preventive Medicine Mechelen Belgium

Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences University of Leuven Leuven Belgium

School of Population Health University of New South Wales The George Institute for Global Health Sydney Australia

Servicio de Clínica Médica Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires Argentina

Zobrazit více v PubMed

Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, Brauer M, Kutty VR, Gupta R, Wielgosz A, AlHabib KF, Dans A, Lopez-Jaramillo P, Avezum A, Lanas F, Oguz A, Kruger IM, Diaz R, Yusoff K, Mony P, Chifamba J, Yeates K, Kelishadi R, Yusufali A, Khatib R, Rahman O, Zatonska K, Iqbal R, Wei L, Bo H, Rosengren A, Kaur M, Mohan V, Lear SA, Teo KK, Leong D, O’Donnell M, McKee M, Dagenais G. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet 2020; 395:795–808. PubMed PMC

GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1223–1249. PubMed PMC

Safar ME, Toto-Moukouo JJ, Bouthier JA, Asmar RE, Levenson JA, Simon AC, London GM. Arterial dynamics, cardiac hypertrophy, and antihypertensive treatment. Circulation 1987; 75:I156–I161. PubMed

O’Rourke MF. Influence of ventricular ejection on the relationship between central aortic and brachial pressure pulse in man. Cardiovasc Res 1970; 4:291–300. PubMed

Avolio AP, Van Bortel LM, Boutouyrie P, Cockcroft JR, McEniery CM, Protogerou AD, Roman MJ, Safar ME, Segers P, Smulyan H. Role of pulse pressure amplification in arterial hypertension: experts’ opinion and review of the data. Hypertension 2009; 54:375–383. PubMed

McEniery CM, Cockcroft JR, Roman MJ, Franklin SS, Wilkinson IB. Central blood pressure: current evidence and clinical importance. Eur Heart J 2014; 35:1719–1725. PubMed PMC

Kollias A, Lagou S, Zeniodi ME, Boubouchairopoulou N, Stergiou GS. Association of central versus brachial blood pressure with target-organ damage: systematic review and meta-analysis. Hypertension 2016; 67:183–190. PubMed

Boutouyrie P, Bussy C, Lacolley P, Girerd X, Laloux B, Laurent S. Association between local pulse pressure, mean blood pressure, and large-artery remodeling. Circulation 1999; 100:1387–1393. PubMed

Covic A, Goldsmith DJ, Panaghiu L, Covic M, Sedor J. Analysis of the effect of hemodialysis on peripheral and central arterial pressure waveforms. Kidney Int 2000; 57:2634–2643. PubMed

Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, Umans JG, Howard BV. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension 2007; 50:197–203. PubMed

Wang KL, Cheng HM, Chuang SY, Spurgeon HA, Ting CT, Lakatta EG, Yin FC, Chou P, Chen CH. Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? J Hypertens 2009; 27:461–467. PubMed PMC

DeLoach SS, Appel LJ, Chen J, Joffe MM, Gadegbeku CA, Mohler ER 3rd, Parsa A, Perumal K, Rafey MA, Steigerwalt SP, Teal V, Townsend RR, Rosas SE. Aortic pulse pressure is associated with carotid IMT in chronic kidney disease: report from Chronic Renal Insufficiency Cohort. Am J Hypertens 2009; 22:1235–1241. PubMed PMC

Manisty CH, Zambanini A, Parker KH, Davies JE, Francis DP, Mayet J, McG Thom SA, Hughes AD; Anglo-Scandinavian Cardiac Outcome Trial Investigators . Differences in the magnitude of wave reflection account for differential effects of amlodipine- versus atenolol-based regimens on central blood pressure: an Anglo-Scandinavian Cardiac Outcome Trial substudy. Hypertension 2009; 54:724–730. PubMed

Roman MJ, Okin PM, Kizer JR, Lee ET, Howard BV, Devereux RB. Relations of central and brachial blood pressure to left ventricular hypertrophy and geometry: the Strong Heart Study. J Hypertens 2010; 28:384–388. PubMed

Wohlfahrt P, Wichterle D, Seidlerová J, Filipovský J, Bruthans J, Adámková V, Cífková R. Relation of central and brachial blood pressure to left ventricular hypertrophy. The Czech Post-MONICA Study. J Hum Hypertens 2012; 26:14–19. PubMed

Nakayama Y, Tsumura K, Yamashita N, Yoshimaru K, Hayashi T. Pulsatility of ascending aortic pressure waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Circulation 2000; 101:470–472. PubMed

Lu TM, Hsu NW, Chen YH, Lee WS, Wu CC, Ding YA, Chang MS, Lin SJ. Pulsatility of ascending aorta and restenosis after coronary angioplasty in patients >60 years of age with stable angina pectoris. Am J Cardiol 2001; 88:964–968. PubMed

Safar ME, Blacher J, Pannier B, Guerin AP, Marchais SJ, Guyonvarc’h PM, London GM. Central pulse pressure and mortality in end-stage renal disease. Hypertension 2002; 39:735–738. PubMed

Hansen TW, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, Jeppesen J. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006; 113:664–670. PubMed

Chirinos JA, Zambrano JP, Chakko S, Veerani A, Schob A, Willens HJ, Perez G, Mendez AJ. Aortic pressure augmentation predicts adverse cardiovascular events in patients with established coronary artery disease. Hypertension 2005; 45:980–985. PubMed

Adji A, O’Rourke MF. Determination of central aortic systolic and pulse pressure from the radial artery pressure waveform. Blood Press Monit 2004; 9:115–121. PubMed

Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, Hughes AD, Thurston H, O’Rourke M; CAFE Investigators; Anglo-Scandinavian Cardiac Outcomes Trial Investigators; CAFE Steering Committee and Writing Committee . Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113:1213–1225. PubMed

Jankowski P, Kawecka-Jaszcz K, Czarnecka D, Brzozowska-Kiszka M, Styczkiewicz K, Loster M, Kloch-Badełek M, Wiliński J, Curyło AM, Dudek D; Aortic Blood Pressure and Survival Study Group . Pulsatile but not steady component of blood pressure predicts cardiovascular events in coronary patients. Hypertension 2008; 51:848–855. PubMed

Redelinghuys M, Norton GR, Scott L, Maseko MJ, Brooksbank R, Majane OH, Sareli P, Woodiwiss AJ. Relationship between urinary salt excretion and pulse pressure and central aortic hemodynamics independent of steady state pressure in the general population. Hypertension 2010; 56:584–590. PubMed

Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, Vita JA, Levy D, Benjamin EJ. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation 2010; 121:505–511. PubMed PMC

Boutouyrie P, Bussy C, Hayoz D, Hengstler J, Dartois N, Laloux B, Brunner H, Laurent S. Local pulse pressure and regression of arterial wall hypertrophy during long-term antihypertensive treatment. Circulation 2000; 101:2601–2606. PubMed

de Luca N, Asmar RG, London GM, O’Rourke MF, Safar ME; REASON Project Investigators . Selective reduction of cardiac mass and central blood pressure on low-dose combination perindopril/indapamide in hypertensive subjects. J Hypertens 2004; 22:1623–1630. PubMed

Drüeke T, Witko-Sarsat V, Massy Z, Descamps-Latscha B, Guerin AP, Marchais SJ, Gausson V, London GM. Iron therapy, advanced oxidation protein products, and carotid artery intima-media thickness in end-stage renal disease. Circulation 2002; 106:2212–2217. PubMed

Pini R, Cavallini MC, Palmieri V, Marchionni N, Di Bari M, Devereux RB, Masotti G, Roman MJ. Central but not brachial blood pressure predicts cardiovascular events in an unselected geriatric population: the ICARe Dicomano Study. J Am Coll Cardiol 2008; 51:2432–2439. PubMed

Dart AM, Gatzka CD, Kingwell BA, Willson K, Cameron JD, Liang YL, Berry KL, Wing LM, Reid CM, Ryan P, Beilin LJ, Jennings GL, Johnston CI, McNeil JJ, Macdonald GJ, Morgan TO, West MJ. Brachial blood pressure but not carotid arterial waveforms predict cardiovascular events in elderly female hypertensives. Hypertension 2006; 47:785–790. PubMed

Sharman JE, Marwick TH, Gilroy D, Otahal P, Abhayaratna WP, Stowasser M; Value of Central Blood Pressure for GUIDing ManagEment of Hypertension Study Investigators . Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study. Hypertension 2013; 62:1138–1145. PubMed

Li Y, Thijs L, Zhang ZY, Asayama K, Hansen TW, Boggia J, Björklund-Bodegård K, Yang WY, Niiranen TJ, Ntineri A, Wei FF, Kikuya M, Ohkubo T, Dolan E, Hozawa A, Tsuji I, Stolarz-Skrzypek K, Huang QF, Melgarejo JD, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Aparicio L, Barochiner J, Gilis-Malinowska N, Narkiewicz K, Kawecka-Jaszcz K, Maestre GE, Jula AM, Johansson JK, Kuznetsova T, Filipovský J, Stergiou G, Wang JG, Imai Y, O’Brien E, Staessen JA; International Database on Ambulatory and Home Blood Pressure in Relation to Cardiovascular Outcome Investigators . Opposing age-related trends in absolute and relative risk of adverse health outcomes associated with out-of-office blood pressure. Hypertension 2019; 74:1333–1342. PubMed PMC

Niiranen TJ, Asayama K, Thijs L, Johansson JK, Ohkubo T, Kikuya M, Boggia J, Hozawa A, Sandoya E, Stergiou GS, Tsuji I, Jula AM, Imai Y, Staessen JA; International Database of Home blood pressure in relation to Cardiovascular Outcome Investigators . Outcome-driven thresholds for home blood pressure measurement: International Database of Home Blood Pressure in Relation to Cardiovascular Outcome. Hypertension 2013; 61:27–34. PubMed PMC

World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. J Am Med Ass 2013;310:2191–2194. PubMed

O’Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T, Myers M, Padfield P, Palatini P, Parati G, Pickering T, Redon J, Staessen J, Stergiou G, Verdecchia P; European Society of Hypertension Working Group on Blood Pressure Monitoring . Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens 2005; 23:697–701. PubMed

Karamanoglu M, O’Rourke MF, Avolio AP, Kelly RP. An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man. Eur Heart J 1993; 14:160–167. PubMed

Pauca AL, O’Rourke MF, Kon ND. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension 2001; 38:932–937. PubMed

Lieber A, Millasseau S, Bourhis L, Blacher J, Protogerou A, Levy BI, Safar ME. Aortic wave reflection in women and men. Am J Physiol Heart Circ Physiol 2010; 299:H236–H242. PubMed

Bos WJ, Verrij E, Vincent HH, Westerhof BE, Parati G, van Montfrans GA. How to assess mean blood pressure properly at the brachial artery level. J Hypertens 2007; 25:751–755. PubMed

Shoji T, Nakagomi A, Okada S, Ohno Y, Kobayashi Y. Invasive validation of a novel brachial cuff-based oscillometric device (SphygmoCor XCEL) for measuring central blood pressure. J Hypertens 2017; 35:69–75. PubMed

Nakagomi A, Shoji T, Okada S, Ohno Y, Kobayashi Y. Validity of the augmentation index and pulse pressure amplification as determined by the SphygmoCor XCEL device: a comparison with invasive measurements. Hypertens Res 2018; 41:27–32. PubMed

Stabouli S, Printza N, Zervas C, Dotis J, Chrysaidou K, Maliahova O, Antza C, Papachristou F, Kotsis V. Comparison of the SphygmoCor XCEL device with applanation tonometry for pulse wave velocity and central blood pressure assessment in youth. J Hypertens 2019; 37:30–36. PubMed

Weber T, Ammer M, Rammer M, Adji A, O’Rourke MF, Wassertheurer S, Rosenkranz S, Eber B. Noninvasive determination of carotid-femoral pulse wave velocity depends critically on assessment of travel distance: a comparison with invasive measurement. J Hypertens 2009; 27:1624–1630. PubMed

Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H; European Network for Non-invasive Investigation of Large Arteries . Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27:2588–2605. PubMed

Milan A, Zocaro G, Leone D, Tosello F, Buraioli I, Schiavone D, Veglio F. Current assessment of pulse wave velocity: comprehensive review of validation studies. J Hypertens 2019; 37:1547–1557. PubMed

Weber T, Wassertheurer S, Hametner B, Parragh S, Eber B. Noninvasive methods to assess pulse wave velocity: comparison with the invasive gold standard and relationship with organ damage. J Hypertens 2015; 33:1023–1031. PubMed

Butlin M, Qasem A. Large artery stiffness assessment using ShygmoCor technology. Pulse 2016; 4:180–192. PubMed PMC

Roglic G, Resnikoff S, Strong K, Unwin N, Alberti KGMM, Bennett PH, Borch-Johnsen K, Colagiuri S, Engelgau M, Home P, Metelko Z, Mohan V, Pan CY, Qiao Q, Ramaija K, Shaw J, Schmidt MI, Tuomilehto J, Vistisen D, Zimmet P. What diagnostic tests should be used to define glycaemic status? In Roglic G, Resnikoff S, Strong K, Unwin N, Guideline Steering Group (eds), Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycaemia. World Health Organization: Geneva, Switzerland, 2006, pp 1–9.

Asayama K, Thijs L, Brguljan-Hitij J, Niiranen TJ, Hozawa A, Boggia J, Aparicio LS, Hara A, Johansson JK, Ohkubo T, Tzourio C, Stergiou GS, Sandoya E, Tsuji I, Jula AM, Imai Y, Staessen JA; International Database of Home Blood Pressure in Relation to Cardiovascular Outcome (IDHOCO) investigators . Risk stratification by self-measured home blood pressure across categories of conventional blood pressure: a participant-level meta-analysis. PLoS Med 2014; 11:e1001591. PubMed PMC

Munné MI. Social consequences of alcohol consumption in Argentina. In Obot IS, Room I (eds), Alcohol, Gender and Drinking Problems. Perspectives from Low and Middle Income Countries. World Health Organization: Geneva, Switzerland, 2005, pp 25–48.

Wilsnack RW, Wilsnack SC, Kristjanson AF, Vogeltanz-Holm ND, Gmel G. Gender and alcohol consumption: patterns from the multinational GENACIS project. Addiction 2009; 104:1487–1500. PubMed PMC

World Health Organization. Global status report on alcohol and health 2018. Geneva, Switzerland, World Health Organization, 2018.

Riley RD, Lambert PC, Abo-Zaid G. Meta-analysis of individual participant data: rationale, conduct, and reporting. BMJ 2010; 340:c221. PubMed

McEniery CM, Yasmin, McDonnell B, Munnery M, Wallace SM, Rowe CV, Cockcroft JR, Wilkinson IB; Anglo-Cardiff Collaborative Trial Investigators . Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff Collaborative Trial II. Hypertension 2008; 51:1476–1482. PubMed

Huang QF, Aparicio LS, Thijs L, Wei FF, Melgarejo JD, Cheng YB, Sheng CS, Yang WY, Gilis-Malinowska N, Boggia J, Niiranen TJ, Wojciechowska W, Stolarz-Skrzypek K, Barochiner J, Ackermann D, Tikhonoff V, Ponte B, Pruijm M, Casiglia E, Narkiewicz K, Filipovský J, Czarnecka D, Kawecka-Jaszcz K, Jula AM, Bochud M, Vanassche T, Verhamme P, Struijker-Boudier HAJ, Wang JG, Zhang ZY, Li Y, Staessen JA; IDCARS (International Database of Central Arterial Properties for Risk Stratification) Investigators . Cardiovascular end points and mortality are not closer associated with central than peripheral pulsatile blood pressure components. Hypertension 2020; 76:350–358. PubMed PMC

Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetière P, Jousilahti P, Keil U, Njølstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM; SCORE project group . Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24:987–1003. PubMed

D’Agostino RB, Jr, Grundy S, Sullivan LM, Wilson P, for the CHD Risk Prediction Group . Validation of the Framingham coronary heart disease predictions scores. Results of a multiple ethnic groups investigation. J Am Med Assoc 2001;286:180–187. PubMed

Huybrechts SA, Devos DG, Vermeersch SJ, Mahieu D, Achten E, de Backer TL, Segers P, van Bortel LM. Carotid to femoral pulse wave velocity: a comparison of real travelled aortic path lengths determined by MRI and superficial measurements. J Hypertens 2011; 29:1577–1582. PubMed

Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, Filipovsky J, Huybrechts S, Mattace-Raso FU, Protogerou AD, Schillaci G, Segers P, Vermeersch S, Weber T; Artery Society; European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries . Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 2012; 30:445–448. PubMed

Sharman JE, Avolio AP, Baulmann J, Benetos A, Blacher J, Blizzard CL, Boutouyrie P, Chen CH, Chowienczyk P, Cockcroft JR, Cruickshank JK, Ferreira I, Ghiadoni L, Hughes A, Jankowski P, Laurent S, McDonnell BJ, McEniery C, Millasseau SC, Papaioannou TG, Parati G, Park JB, Protogerou AD, Roman MJ, Schillaci G, Segers P, Stergiou GS, Tomiyama H, Townsend RR, Van Bortel LM, Wang J, Wassertheurer S, Weber T, Wilkinson IB, Vlachopoulos C. Validation of non-invasive central blood pressure devices: ARTERY Society task force consensus statement on protocol standardization. Eur Heart J 2017; 38:2805–2812. PubMed PMC

Hope SA, Meredith IT, Cameron JD. Effect of non-invasive calibration of radial waveforms on error in transfer-function-derived central aortic waveform characteristics. Clin Sci (Lond) 2004; 107:205–211. PubMed

Kobayashi H, Kinou M, Takazawa K. Correlation between the brachial blood pressure values obtained using the cuff method and central blood pressure values obtained invasively. Intern Med 2013; 52:1675–1680. PubMed

Hunyor SN, Flynn JM, Cochineas C. Comparison of performance of various sphygmomanometers with intra-arterial blood-pressure readings. Br Med J 1978; 2:159–162. PubMed PMC

Verbeke F, Segers P, Heireman S, Vanholder R, Verdonck P, Van Bortel LM. Noninvasive assessment of local pulse pressure: importance of brachial-to-radial pressure amplification. Hypertension 2005; 46:244–248. PubMed

Papaioannou TG, Karageorgopoulou TD, Sergentanis TN, Protogerou AD, Psaltopoulou T, Sharman JE, Weber T, Blacher J, Daskalopoulou SS, Wassertheurer S, Khir AW, Vlachopoulos C, Stergiopulos N, Stefanadis C, Nichols WW, Tousoulis D. Accuracy of commercial devices and methods for noninvasive estimation of aortic systolic blood pressure a systematic review and meta-analysis of invasive validation studies. J Hypertens 2016; 34:1237–1248. PubMed

Babbs CF. Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model. Biomed Eng Online 2012; 11:56. PubMed PMC

Melgarejo JD, Yang WY, Thijs L, Li Y, Asayama K, Hansen TW, Wei FF, Kikuya M, Ohkubo T, Dolan E, Stolarz-Skrzypek K, Huang QF, Tikhonoff V, Malyutina S, Casiglia E, Lind L, Sandoya E, Filipovský J, Gilis-Malinowska N, Narkiewicz K, Kawecka-Jaszcz K, Boggia J, Wang JG, Imai Y, Vanassche T, Verhamme P, Janssens S, O’Brien E, Maestre GE, Staessen JA, Zhang ZY; International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators . Association of fatal and nonfatal cardiovascular outcomes with 24-hour mean arterial pressure. Hypertension 2021; 77:39–48. PubMed PMC

Segers P, Mahieu D, Kips J, Van Bortel LM. The use of a generalized transfer function: different processing, different results! J Hypertens 2007; 25:1783–1787. PubMed

Chen CH, Nevo E, Fetics B, Pak PH, Yin FC, Maughan WL, Kass DA. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation 1997; 95:1827–1836. PubMed

Sharman JE, Lim R, Qasem AM, Coombes JS, Burgess MI, Franco J, Garrahy P, Wilkinson IB, Marwick TH. Validation of a generalized transfer function to noninvasively derive central blood pressure during exercise. Hypertension 2006; 47:1203–1208. PubMed

Medical Services Advisory Commitee. Peripheral Arterial Tonometry with Ascending Aortic Waveform Analysis Using the SphygmoCor System. February/March 2006. Application 1079. Assessment report. Commonwealth of Australia: Canberra, Australia, 2006.

Wei FF, Thijs L, Cauwenberghs N, Yang WY, Zhang ZY, Yu CG, Kuznetsova T, Nawrot TS, Struijker-Boudier HAJ, Verhamme P, Vermeer C, Staessen JA. Central hemodynamics in relation to circulating desphospho-uncarboxylated matrix Gla protein: a population study. J Am Heart Assoc 2019; 8:e011960. PubMed PMC

Cauwenberghs N, Knez J, D’hooge J, Thijs L, Yang WY, Wei FF, Zhang ZY, Staessen JA, Kuznetsova T. Longitudinal changes in LV structure and diastolic function in relation to arterial properties in general population. JACC Cardiovasc Imaging 2017; 10:1307–1316. PubMed

Shiburi CP, Staessen JA, Maseko M, Wojciechowska W, Thijs L, Van Bortel LM, Woodiwiss AJ, Norton GR. Reference values for SphygmoCor measurements in South Africans of African ancestry. Am J Hypertens 2006; 19:40–46. PubMed

Li Y, Staessen JA, Li LH, Huang QF, Lu L, Wang JG. Reference values for the arterial pulse wave in Chinese. Am J Hypertens 2008; 21:668–673. PubMed

Cheng HM, Chuang SY, Sung SH, Yu WC, Pearson A, Lakatta EG, Pan WH, Chen CH. Derivation and validation of diagnostic thresholds for central blood pressure measurements based on long-term cardiovascular risks. J Am Coll Cardiol 2013; 62:1780–1787. PubMed PMC

Wojciechowska W, Staessen JA, Nawrot T, Cwynar M, Seidlerová J, Stolarz K, Gasowski J, Tichá M, Richart T, Thijs L, Grodzicki T, Kawecka-Jaszcz K, Filipovský J; European Project on Genes in Hypertension (EPOGH)Investigators . Reference values in white Europeans for the arterial pulse wave recorded by means of the SphygmoCor device. Hypertens Res 2006; 29:475–483. PubMed

Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave

An outcome-driven threshold for pulse pressure amplification

Derivation of an Outcome-Driven Threshold for Aortic Pulse Wave Velocity: An Individual-Participant Meta-Analysis

Risk Stratification by Cross-Classification of Central and Brachial Systolic Blood Pressure