Abstract: TH-PO689
Hypertension Is Associated with Adverse Cardiovascular Outcomes Only When Both Brachial and Central Blood Pressures Are Elevated
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention
Authors
- Lamarche, Florence, Hopital du Sacre-Coeur de Montreal, Montreal, 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
The range of central blood pressure (BP) found in individuals with high-normal brachial BP overlaps the one found in hypertension (HTN) and normotension. As central BP is possibly a better predictor of cardiovascular (CV) disease, the aim of this study was to determine the risk associated with different central/brachial BP patterns.
Methods
13,759 participants from a populational cohort with central BP and prospective data from governmental databases who were not treated for HTN were selected. Major adverse CV events (MACE) comprised myocardial infarction, stroke, heart failure and CV death. Thresholds for brachial and central HTN were identified as 135 and 125 mmHg respectively. Individuals were separated into 4 BP patterns: normal BP; isolated brachial HTN; isolated central HTN; concordant brachial and central HTN. CVE risk for each pattern was compared to normal BP with a Cox proportional hazard model.
Results
688 MACE occurred over a median follow-up of 70.0 months. Characteristics of individuals in each BP phenotype are presented in Table 1. Only the concordant brachial and central HTN pattenr had higher risk of MACE [HR 1.37 95%CI (1.15-1.64), p=0.001] compared to normal BP (Figure 1). Sensitivity analyses with different definitions of central HTN and after stratification for sex yielded similar results.
Conclusion
In untreated individuals, both central and brachial BP need to be elevated to increase CV risk. These findings provide support for the utility of routine central BP measurements in clinical practice.