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. 2021 Apr 1;39(4):607-613.
doi: 10.1097/HJH.0000000000002694.

Invasive aortic pulse pressure is not superior to cuff pulse pressure in cardiovascular risk prediction

Esben Laugesen  1   2 , Søren T Knudsen  3 , Klavs W Hansen  4 , Niklas B Rossen  1 , Lisette Okkels Jensen  5 , Michael S Hansen  6 , Lone K Andersen  7 , Kristian K Thomsen  8 , Hanne Søndergaard  9 , Morten Böttcher  10 , Bent Raungaard  11 , Kevin K W Olesen  12 , Michael Mæng  12 , Hans Erik Bøtker  12 , Per L Poulsen  1   3
Affiliations

Invasive aortic pulse pressure is not superior to cuff pulse pressure in cardiovascular risk prediction

Esben Laugesen et al. J Hypertens. .

Abstract

Objective: Aortic pulse pressure (PP) represents the hemodynamic cardiac and cerebral burden more directly than cuff PP. The objective of this study was to investigate whether invasively measured aortic PP confers additional prognostic value beyond cuff PP for cardiovascular events and death. With increasing age, cuff PP progressively underestimates aortic PP. Whether the prognostic association between cuff PP and outcomes is age-dependent remains to be elucidated.

Methods: Cuff PP and invasively measured aortic PP were recorded in 21 908 patients (mean age 63 years, 58% men, 14% with diabetes) with stable angina pectoris undergoing elective coronary angiography during January 2001--December 2012. Multivariate Cox models were used to assess the association with incident myocardial infarction, stroke, and death. Discrimination was assessed using Harrell's C-index.

Results: During a median follow-up period of 3.7 years (range 0.1-10.8 years), 422 strokes, 511 myocardial infarctions, and 1530 deaths occurred. Both cuff and aortic PP were associated with stroke, myocardial infarction, and death in crude analyses. However, only cuff PP remained associated with stroke (hazard ratio per 10 mmHg, 1.06 (95% confidence interval (CI) 1.01--1.12)] and myocardial infarction [hazard ratio per 10 mmHg 1.05 (95% CI 1.01--1.11)] in multivariate Cox models. Both cuff and aortic PP lost significance as predictors of death in multivariate models. Age did not modify the prognostic association between cuff PP and stroke, myocardial infarction, and death.

Conclusion: Invasively measured aortic PP did not add prognostic information about cardiovascular outcomes and death beyond cuff PP in patients with stable angina pectoris.

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Comment in

  • Age issue in the pressure equivalence method.
    Zanoli L, Boutouyrie P. Zanoli L, et al. J Hypertens. 2021 May 1;39(5):1046-1047. doi: 10.1097/HJH.0000000000002789. J Hypertens. 2021. PMID: 33824262 No abstract available.
  • Reply.
    Laugesen E, Poulsen PL. Laugesen E, et al. J Hypertens. 2021 May 1;39(5):1047-1048. doi: 10.1097/HJH.0000000000002790. J Hypertens. 2021. PMID: 33824263 No abstract available.
  • 'Apples to oranges' and 'Less is more'.
    Argyris AA, Samara S, Blacher J, Papaioannou TG, Stergiou GS, Vlachopoulos C, Wassertheurer S, Weber T, Protogerou AD. Argyris AA, et al. J Hypertens. 2021 Jun 1;39(6):1262-1264. doi: 10.1097/HJH.0000000000002827. J Hypertens. 2021. PMID: 33967221 No abstract available.
  • Reply.
    Laugesen E, Poulsen PL. Laugesen E, et al. J Hypertens. 2021 Jun 1;39(6):1264-1265. doi: 10.1097/HJH.0000000000002828. J Hypertens. 2021. PMID: 33967222 No abstract available.

References

    1. Nichols WW, O’Rourke M, Vlachopoulos C. Mcdonald's blood flow in arteries. 2011; London: Hodder Arnold, 415–446.
    1. Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation 2010; 121:505–511.
    1. Safar ME, Blacher J, Pannier B, Guerin AP, Marchais SJ, Guyonvarc’h PM, London GM. Central pulse pressure and mortality in end-stage renal disease. Hypertension 2002; 39:735–738.
    1. Vlachopoulos C, Aznaouridis K, O’Rourke MF, Safar ME, Baou K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J 2010; 31:1865–1871.
    1. Pini R, Cavallini MC, Palmieri V, Marchionni N, Di BM, Devereux RB, et al. Central but not brachial blood pressure predicts cardiovascular events in an unselected geriatric population: The icare dicomano study. J Am Coll Cardiol 2008; 51:2432–2439.

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