Baseline predictors of central aortic blood pressure: A PEAR substudy

• Type of Material: Article
• Authors: Rebecca Rosenwasser, University of Florida; Niren K. Shah, University of Florida; Steven M. Smith, University of Colorado Aurora; Xuerong Wen, University of Florida; Yan Gong, University of Florida; John G. Gums, University of Florida; Wilmer W. Nichols, University of Florida; Arlene B Chapman, Emory University; Eric Boerwinkle, University of Texas Health Science Center; Julie Johnson, University of Florida; Benjamin Epstein, University of Florida
• Language: English
• Date: 2014-03-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 American Society of Hypertension. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jash.2013.12.008
• Title of Journal or Parent Work: Journal of the American Society of Hypertension
• ISSN: 1933-1711
• Volume: 8
• Issue: 3
• Start Page: 152
• End Page: 158
• Grant/Funding Information: This work is a substudy of Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR), which was supported by the National Institute of Health Pharmacogenetics Research Network grant U01-GM074492; and the National Center for Advancing Translational Sciences under the award number UL1 TR000064 (University of Florida).
• Keywords: Peripheral Vascular Disease; HEART-RATE; Cardiovascular System & Cardiology; CENTRAL HEMODYNAMICS; COLLABORATIVE TRIAL ACCT; Life Sciences & Biomedicine; AMPLIFICATION; pulse wave analysis; arterial pressure; applanation tonometry; vascular stiffness; blood pressure; CARDIOVASCULAR RISK-FACTORS; ARTERIAL STIFFNESS; HYPERTENSIVE SUBJECTS; Science & Technology; Hypertension; ALL-CAUSE; cardiovascular disease; PULSE PRESSURE; WAVE REFLECTION
• Research Categories: Health Sciences, Pharmacology; Health Sciences, Medicine and Surgery

Abstract

Elevated central systolic blood pressure (BP) increases the risk of cardiovascular events and appears superior to peripheral BP for long term risk prediction. The objective of this study was to identify demographic and clinical factors associated with central pressures in patients with uncomplicated hypertension. We prospectively examined peripheral BP, central aortic BP, and arterial wall properties and wave reflection in 57 subjects with uncomplicated essential hypertension in the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) Study. Significant predictors of central SBP included height, smoking status, heart rate (HR), and peripheral systolic BP (SBP), while central diastolic BP (DBP) was explained by peripheral DBP and HR. These variables accounted for nearly all of the variability in central SBP and central DBP (R 2 = 0.94 and R 2 = 0.98, respectively). Central pulse pressure variability was largely explained by gender, ex-smoking status, HR, peripheral SBP, and peripheral DBP (R 2 = 0.94). Central augmented pressure had a direct relationship with smoking status, peripheral SBP, and duration of hypertension, whereas it was indirectly related to height, HR, and peripheral DBP. Easily obtainable demographic and clinical factors are associated with central pressures in essential hypertensive persons. These relationships should be considered in future studies to improve assessment of BP to reduce cardiovascular risk and mortality.