Abstract: PO1787
Central Blood Pressure Calibration Method and Cardiovascular Risk Prediction According to Sex
Session Information
- Hypertension and CVD: Clinical, Outcomes, and Trials
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1402 Hypertension and CVD: Clinical, Outcomes, and Trials
Authors
- Lamarche, Florence, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
- Agharazii, Mohsen, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
- Nadeau-Fredette, Annie-Claire, Hopital Maisonneuve-Rosemont, Montreal, 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 accuracy of central BP is improved when calibrated on the mean BP and diastolic BP (C2SBP) compared to calibration on the systolic BP and diastolic BP (C1SBP). Furthermore, preliminary data suggest C2SBP may have the best accuracy in females. We aim to assess whether this enhanced accuracy translates into improved cardiovascular (CV) risk prediction when compared to brachial SBP (bSBP) and C1SBP in the general population and stratified by sex.
Methods
12,927 participants exempt of known CV disease, with prospective follow-up from administrative databases and central BP measurements were included. The SphygmoCor Px device was used to estimate C1SBP. C2SBP was derived from unprocessed radial pressure waveforms extracted from SphygmoCor output data, which was recalibrated with diastolic BP and 40% form factor derived mean BP. Participants with heart rate <60 were excluded due to incomplete waveforms. Major adverse CV events (MACE) comprised myocardial infarction, stroke, heart failure with hospitalization and CV death. Multivariable Cox regressions, differences in area under the curve, net reclassification index and integrated discrimination index were calculated comparing C2SBP to C1SBP and to bSBP.
Results
Over a median follow-up of 10.1 years (IQR 9.9-10.3), there were 2125 MACE (723/7013 females and 860/5934 males). All BP parameters were significantly associated with MACE, regardless of sex. In the overall cohort, risk prediction metrics marginally favored C2SBP compared to bSBP, but were similar to C1SBP. No significant improvement of CV risk prediction was found in sex-stratified analyses (see Table).
Conclusion
C2SBP marginally improved CV risk prediction when compared to bSBP but not C1SBP in the overall cohort only. All three BP parameters were similarly predictive in both sex, although this analysis possibly lacked power. This may be related to the FF-derived MAP (rather than oscillometric MAP), which is highly dependent on the brachial SBP.