2.1 THE RELATIVE IMPORTANCE OF CENTRAL AND BRACHIAL BLOOD PRESSURE IN PREDICTING CARDIOVASCULAR EVENTS: AN INDIVIDUAL PARTICIPANT META-ANALYSIS OF PROSPECTIVE OBSERVATIONAL DATA FROM 22,433 SUBJECTS

Carmel McEniery; Yoav Ben-Shlomo; Margaret May; Melissa Spears; Lyndia Brumback; James Cameron; Chen-Huan Chen; Julio Chirinos; Danuta Czarnecka; Anthony Dart; Richard Devereux; Neeraj Dhaun; Daniel Duprez; Shih-Jen Hwang; David Jacobs; Piotr Jankowski; Julie Janner; Peter Lacy; Gary Mitchell; Riccardo Pini

doi:10.1016/j.artres.2016.10.005

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Volume 16, Issue C, December 2016, Pages 49 - 49

2.1 THE RELATIVE IMPORTANCE OF CENTRAL AND BRACHIAL BLOOD PRESSURE IN PREDICTING CARDIOVASCULAR EVENTS: AN INDIVIDUAL PARTICIPANT META-ANALYSIS OF PROSPECTIVE OBSERVATIONAL DATA FROM 22,433 SUBJECTS

Authors

Carmel McEniery¹, Yoav Ben-Shlomo², Margaret May², Melissa Spears², Lyndia Brumback³, James Cameron⁴, Chen-Huan Chen⁵, Julio Chirinos⁶, Danuta Czarnecka⁷, Anthony Dart⁴, Richard Devereux⁸, Neeraj Dhaun⁹, Daniel Duprez¹⁰, Shih-Jen Hwang¹¹, David Jacobs¹⁰, Piotr Jankowski⁷, Julie Janner¹², Peter Lacy¹³, Gary Mitchell¹⁴, Riccardo Pini¹⁵

¹University of Cambridge, UK

²University of Bristol, UK

³University of Washington, USA

⁴Monash University, Melbourne, Australia

⁵National Yan-Ming University, Taipei, Taiwan

⁶University of Pennsylvania, Philadelphia, USA

⁷Jagiellonian University, Krakow, Poland

⁸Weill Cornell Medical College, New York, USA

⁹University of Edinburgh, UK

¹⁰University of Minnesota, Minneapolis, USA

¹¹NHLBI, Framingham, USA

¹²Bispebjerg University Hospital, Copenhagen, Denmark

¹³University College London, UK

¹⁴Cardiovascular Engineering Inc., Norwood, USA

¹⁵University of Florence, Italy

Available Online 24 November 2016.

DOI: 10.1016/j.artres.2016.10.005 How to use a DOI?
Abstract: Systolic blood pressure (SBP) differs between the brachial artery and aorta. Prospective data suggest that central pressure predicts future cardiovascular events, but it is unclear if it is superior to brachial pressure.

Methods and Results: A systematic review and individual participant data meta-analysis from 15 studies was undertaken. Study-specific associations of central and brachial pressure with cardiovascular outcomes, with and without mutual adjustment, were determined using Cox proportional hazard models, and random effect models to estimate pooled estimates. Of 22,433 participants, 908 had a myocardial infarction (MI) and 641 a stroke. The pooled age, sex, height and heart rate adjusted hazard ratio (HR) [95% CI] per SD increase in brachial SBP was 1.17 [1.03, 1.32] for MI and 1.28 [1.13, 1.46] for stroke and 1.16 [1.02, 1.33] and 1.33 [1.15, 1.53] for central SBP, respectively. Mutual adjustment attenuated the HRs for MI: brachial SBP (1.16 [0.90, 1.48]), central SBP (1.09 [0.87, 1.38]) and stroke: brachial SBP (1.18 [0.97, 1.42]), central SBP (1.19 [0.99, 1.44]). However, associations between central SBP and stroke, after adjustment for brachial SBP, were higher in those aged <61 years than in older individuals (1.83 versus 1.08 p-interaction <0.001).

Conclusion: Brachial and central SBP have similar associations with future CV events. Larger studies are required to test whether central SBP may be a more powerful predictor of stroke risk in younger individuals.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 16 - C
Pages: 49 - 49
Publication Date: 2016/11/24
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2016.10.005 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - Carmel McEniery
AU  - Yoav Ben-Shlomo
AU  - Margaret May
AU  - Melissa Spears
AU  - Lyndia Brumback
AU  - James Cameron
AU  - Chen-Huan Chen
AU  - Julio Chirinos
AU  - Danuta Czarnecka
AU  - Anthony Dart
AU  - Richard Devereux
AU  - Neeraj Dhaun
AU  - Daniel Duprez
AU  - Shih-Jen Hwang
AU  - David Jacobs
AU  - Piotr Jankowski
AU  - Julie Janner
AU  - Peter Lacy
AU  - Gary Mitchell
AU  - Riccardo Pini
PY  - 2016
DA  - 2016/11/24
TI  - 2.1 THE RELATIVE IMPORTANCE OF CENTRAL AND BRACHIAL BLOOD PRESSURE IN PREDICTING CARDIOVASCULAR EVENTS: AN INDIVIDUAL PARTICIPANT META-ANALYSIS OF PROSPECTIVE OBSERVATIONAL DATA FROM 22,433 SUBJECTS
JO  - Artery Research
SP  - 49
EP  - 49
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.005
DO  - 10.1016/j.artres.2016.10.005
ID  - McEniery2016
ER  -

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