ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: SA-PO905

Central Systolic and Pulse Pressures as Predictors of Cardiovascular Events: A Prospective Study

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Lamarche, Florence, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Desbiens, Louis-Charles, Université Laval, Québec, Quebec, Canada
  • Mac-Way, Fabrice, CHU de Quebec, Hotel-Dieu de Quebec Hospital, Quebec, Quebec, Canada
  • Agharazii, Mohsen, CHUQ-HDQ, Quebec City, Quebec, Canada
  • Madore, Francois, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Goupil, Remi, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
Background

Central blood pressure (BP) is proposed as a better predictor of cardiovascular (CV) burden than peripheral BP. Nevertheless, its clinical value remains to be determined. This study aims to characterize the role of central BP in CV risk stratification.

Methods

We included 15,923 CARTaGENE participants with available central BP (SphygmoCor Px; type I device) and prospective data from an administrative healthcare database. Major adverse CV events (MACE) included myocardial infarction, stroke, heart failure with hospitalization and CV death. The associations between of brachial and central BP parameters with MACE were assessed using Cox regressions adjusting for: age, sex, BMI, smoking, diabetes, known CV disease, HbA1c, LDL-c, eGFR, uric acid, heart rate, use of beta-blockers, renin-angiotensin system blockers, calcium channel blockers, diuretics, aspirin, clopidogrel and anticoagulants. Restricted cubic splines were performed to account for nonlinear associations.

Results

1,399 MACE occurred over a median follow-up of 70 months. Significant associations between central and brachial systolic and pulse pressures (PP) and MACE were found (Figure 1). Increments of 5 mmHg in brachial and central systolic BP were both associated with increased risk [HR 1.04 (95%CI 1.01-1.06), p<0.005, for both], which was significant at BPs greater than 130 mmHg and 140 mmHg respectively. HRs remained similar at higher values of systolic BP and PP.

Conclusion

There is a significant association between MACE and both central and brachial systolic BP and PP. There appears to be a similar relationship between central and brachial BP parameters and CV risk but with different thresholds. In this regard, central BP alone estimated with SphygmoCor may not provide an added benefit in CV risk stratification compared to brachial BP.