Aortic, but not brachial blood pressure category enhances the ability to identify target organ changes in normotensives

被引:14
作者
Booysen, Hendrik L. [1 ]
Norton, Gavin R. [1 ]
Maseko, Muzi J. [1 ]
Libhaber, Carlos D. [2 ]
Majane, Olebogeng H. I. [1 ]
Sareli, Pinhas [1 ]
Woodiwiss, Angela J. [1 ]
机构
[1] Univ Witwatersrand, Sch Physiol, Cardiovasc Pathophysiol & Genom Res Unit, ZA-2193 Johannesburg, South Africa
[2] Univ Witwatersrand, Fac Hlth Sci, Sch Med, ZA-2193 Johannesburg, South Africa
基金
英国医学研究理事会; 新加坡国家研究基金会;
关键词
aortic BP; normal/high-normal BP; risk factors; target organ changes; PREDICTS CARDIOVASCULAR EVENTS; SECONDARY PREVENTION; CORONARY-DISEASE; PULSE PRESSURE; HIGH-RISK; PREHYPERTENSION; HYPERTENSION; POPULATION; IMPACT; PERINDOPRIL;
D O I
10.1097/HJH.0b013e328360802a
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Aims: We sought to determine whether within normal/high-normal blood pressure (BP) ranges (120-139/80-89 mmHg), aortic BP may further refine BP-related cardiovascular risk assessment, as determined from target organ changes. Methods: In 1169 participants from a community sample of African ancestry, 319 (27%) of whom had a normal/high-normal BP, aortic BP was determined using radial applanation tonometry and SphygmoCor software, and target organ changes assessed from carotid-femoral pulse wave velocity (PWV) (n = 1025), estimated glomerular filtration rate (eGFR) (n = 944), and left ventricular mass indexed to height(2.7) (LVMI) (n = 690). Results: Normal versus high-normal BP categories failed to differentiate between those participants with a BP above optimal values with versus without multivariate-adjusted target organ changes. However, in those with a normal/high-normal BP with aortic SBP values that were less than 95% confidence interval of healthy participants with optimal BP values (45% of those with a normal/high-normal BP), no unadjusted or multivariateadjusted target organ changes were noted. In contrast, those with a normal/high-normal BP with aortic SBP values that exceeded optimal thresholds, demonstrated unadjusted and multivariate adjusted increases in PWV and LVMI and decreases in eGFR (P<0.05 to P<0.005 after multivariate adjustments). Conclusion: In contrast to normal versus high-normal BP categories which do not clearly distinguish normotensives with from those without organ damage, noninvasively determined aortic BP measurements may refine the ability to detect those with a normal/high-normal BP at risk of BP-related cardiovascular damage.
引用
收藏
页码:1124 / 1130
页数:7
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