Objective: The aim was to evaluate the association of central BP with target organ damage (TOD) and the risk of future hypertension in a cohort of subjects from the HARVEST study. Methods. We studied 305 stage I hypertensive subjects (mean age, 38±10 years). Central BP was obtained from radial artery tonometry. TOD included left ventricular hypertrophy and/or microalbuminuria.

Results: At baseline peripheral BP was 138±12/86±7 mmHg, average 24-hour BP was 130±11/80±8 mmHg, central BP was 125±13/86±8 mmHg. In a multiple logistic regression including ambulatory BP, central mean BP was associated with TOD (p=0.01). In the subjects divided according to whether their central mean BP was above or below the median (98.7 mmHg), during 9-year follow-up, sustained hypertension was developed by 38.8% of subjects with low central mean BP and by 64.5% of subjects with high central mean BP (p<0.001). Central mean BP was used because it was a better predictor of future hypertension (OR 2.5) compared to central SBP or DBP. In a multiple logistic regression central mean BP and not central pulse pressure, was an independent predictor of future hypertension (p=0.004). Also ambulatory systolic (p=0.002) and diastolic (p=0.02) BPs were independent predictors. When all pressures were included in the same model, central mean BP remained a predictor of future hypertension (p=0.004) on top of ambulatory BP.

Conclusion: In young-to-middle-age stage I hypertensive subjects central mean BP, but not pulse pressure, was associated with TOD and central BP was a significant predictor of adverse outcome on top of 24-hour BP.