Objective: Recently central aortic blood pressures were shown to be better predictors of target organ damage, cardiovascular events and mortality when compared with conventional brachial blood pressure. Whether central blood pressure is a better predictor of left ventricular hypertrophy (LVH) determined by electrocardiographic criteria is not know.

Methods: Radial applanation tonometry and ECG were performed in 563 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, mean age 46±11 years, 44% of men). LVH was determined using electrocardiographic criteria. Brachial blood pressure was measured using mercury sphygmomanometer according to standardized protocol; central systolic blood pressure was derived from radial pulse wave using generalised transfer function.

Results: Of 563 subjects 39 (7%) had ECG signs of LVH. In the univariate analysis patients with LVH were older (50.4±11.3 vs. 46.6±11.3, p=0.04), had higher central systolic (129.7±31.8 vs. 116.7±16.8, p< 0.0001), diastolic (83.3±10.3 vs. 79.2±9.7, p=0.04), pulse (46.5±13.1 vs. 37.5±12, p< 0.0001) and mean pressure (103.5±14.8 vs.96±11.8, p< 0.01), higher brachial systolic (136.6±19.4 vs. 122.8±14.8, p< 0.0001),pulse (67.2±19.3 vs. 52.6±16.8, p< 0.0001) and mean (91.8±10.3 vs. 87.2±8.9,p=0.02) pressure and aortic pulse wave velocity (8.3±2.1 vs. 7.5±1.8, p=0.02) then subjects without LVH. However, in the binary logistic regression only central systolic pressure (OR 2.2, 95% CI 1.4–3.4, p=0.001) and male sex (OR 4.8, 95% CI 1.3–17.6, p=0.02) were predictors of LVH.

Conclusion: Noninvasively determined central systolic blood pressure is more strongly related to LVH determined by electrocardiographic criteria then brachial systolic and pulse pressure. This is a further support of closer association of central blood pressure with target organ damage. Prospective studies with central blood pressure as a treatment target will be needed in the future.