Abstract 5145: Central or Ambulatory Peripheral Blood Pressure: Which Best Relates to Target-organs and Future Mortality?
Background: Central blood pressure (CBP) relates more to target organs and future cardiovascular mortality than peripheral blood pressure. It remains unknown whether single measurement of CBP is superior to multiple measurements of peripheral blood pressure from ambulatory blood pressure (AmBP) monitoring in the association with target organs and future mortality.
Methods: CBP by carotid tonometry and 24-hour AmBP from a community-based population of 943 participants were analyzed. Cross-sectional association of the various blood pressure variables with left ventricular mass (LVM), carotid intima-media thickness (IMT), and estimated glomerular filtration rate (eGFR), and longitudinal association with all-cause and cardiovascular mortality over a 14.9-year median follow-up were investigated.
Results: Among the 4 blood pressure variables, including the 24-hour SBP-Am and PP-Am, and SBP-C and PP-C, LVM correlated best with SBP-Am, whereas IMT and eGFR correlated best with PP-C. All 4 blood pressure variables, as well as target-organ indices predicted 14.9-year all-cause and cardiovascular mortality in the univariate analysis. With adjustment for conventional risk factors as well as LVM, IMT, and eGFR, individually entered SBP-Am, PP-Am, SBP-C or PP-C independently predicted cardiovascular mortality but not all-cause mortality. When the blood pressure variables were jointly entered into the multivariate models, only SBP-Am consistently predicted cardiovascular mortality.
Conclusion: SBP-Am and PP-C relate differently to different target-organs. SBP-Am is more powerful than SBP-C or PP-C in the prediction of cardiovascular mortality.