ICHIHARA Atsuhiro
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Peer reviewed
Title The Relationships between the Differences in the Central Blood Pressure and Brachial Blood Pressure and Other Factors in Patients with Essential Hypertension.
Journal Formal name:Internal medicine (Tokyo, Japan)
Abbreviation:Intern Med
ISSN code:(13497235)09182918(Linking)
Volume, Issue, Page 56(6),pp.587-596
Author and coauthor RYUZAKI Masaki†, MORIMOTO Satoshi, NIIYAMA Michita, SEKI Yasufumi, YOSHIDA Naohiro, OSHIMA Yoichi, MIZUGUCHI Yuki, WATANABE Daisuke, ANDO Takashi, ICHIHARA Atsuhiro
Publication date 2017
Summary Objective The management of blood pressure (BP) in hypertensive patients is the key to preventing a progression of organ damage. The brachial BP (bBP) has been used as the representative method for measuring the BP. The central BP (cBP), which is, different from the bBP due to the propagation and the reflection of the pulse wave in the arterial system, has recently received attention because it can now be estimated non-invasively. We examined the relationships between the difference in the central systolic BP (csBP) and the brachial systolic BP (bsBP) (Δ) and other factors in hypertensive patients. Methods The bsBP and csBP were measured in patients with essential hypertension and the relationships between the bsBP, csBP, or Δ and background factors including age, the brain natriuretic peptide (BNP) level, the estimated glomerular filtration rate (eGFR), flow-mediated vasodilation (an index of vascular endothelial function), the cardio-ankle vascular index (CAVI, an index of arteriosclerosis), and the carotid intima-media thickness (an index of atherosis) were investigated. Results The data of 191 patients were analyzed. Although there was no significant correlation between the CAVI and the bsBP; positive correlations were observed between the CAVI and the csBP (r=0.249, p=0.001). The Δ value showed significant positive correlations with age, and the BNP, eGFR, and CAVI values. Conclusion The csBP is more strongly associated with arteriosclerosis than the bsBP. Moreover, the Δ value is more strongly associated with cardiac function, renal function, and arteriosclerosis than the bsBP or csBP. These data suggested that the Δ value may have a greater prognostic value than the bsBP or csBP and may be worth calculating in the clinical setting.
DOI 10.2169/internalmedicine.56.7597
PMID 28321055