Central Blood Pressure Beats Brachial As Prognostic Tool

Central blood pressure more accurately predicts cardiovascular risk in elderly than brachial blood pressure

THURSDAY, June 19 (HealthDay News) -- Central blood pressure is a superior predictor of cardiovascular events than brachial blood pressure and should be considered in determining the effectiveness of treatment on patients, according to research published in the June 24 issue of the Journal of the American College of Cardiology.

Riccardo Pini, M.D., of the University of Firenze and Azienda Ospedaliero-Universitaria Careggi in Florence, Italy, and colleagues conducted a prospective study of residents of Dicomano, Italy, who were 65 years of age or older and either normotensive (173 subjects) or untreated hypertensives (95 diastolic and 130 isolated systolic). Subjects underwent rigorous clinical evaluation of their cardiovascular status in 1995 and were re-evaluated in 2003 for vital status and cardiovascular events.

The researchers report that higher carotid systolic blood pressure and pulse pressure predicted cardiovascular events independent of the patients' age and gender, in a multivariate analysis. The study revealed 106 deaths, 45 of which were cardiovascular, and 122 cardiovascular events over an eight-year period. These findings support earlier studies demonstrating that increased central pulse pressure is linked to greater left ventricular mass/body surface area, vascular remodeling and carotid atherosclerosis, the authors state.

In an accompanying editorial, Michel E. Safar, M.D., and Jacques Blacher, M.D., Ph.D., of Hotel-Dieu Hospital, Diagnosis Center in Paris, France, write that the result "largely reflects the role of age on the development of atherosclerotic carotid complications in elderly individuals."

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