2.2 TRANSFER FUNCTION-DERIVED CENTRAL PRESSURE AND CARDIOVASCULAR EVENTS: THE FRAMINGHAM HEART STUDY

DOI

10.1016/j.artres.2013.10.008How to use a DOI?

Abstract

Relations between central versus brachial blood pressure and major cardiovascular disease (CVD) events remain controversial. Central measures derived using radial tonometry and a generalized transfer function as implemented using the SphygmoCor device may better predict CVD risk compared to central pressures from carotid tonometry. We used proportional hazards models to examine relations of augmentation index, central systolic and pulse pressure, and central-to-peripheral pulse pressure amplification obtained using the Sphygmocor algorithm to first-onset major CVD events in 2183 participants (mean age 62 years, 58% women) in the Framingham Heart Study. During median follow-up of 7.8 (range 0.2 to 8.9) years, 149 participants (6.8%) had an incident event. Augmentation index (P = 0.6), central systolic pressure (P = 0.20), central pulse pressure (P = 0.24) and pulse pressure amplification (P = 0.15) were not related to outcomes in models that adjusted for age, sex, clinic systolic blood pressure, use of antihypertensive therapy, total and high density lipoprotein cholesterol concentrations, smoking, and presence of diabetes. When models were repeated using supine oscillometric systolic pressure recorded at the time of tonometry and excluding cases with tonometry pulse height variations >5%, pulse diastolic variation >5%, pulse shape variation >4% or an operator index <80, as recommended by SphygmoCor documentation (N = 1262, 64 events), central pulse pressure estimated using the SphygmoCor algorithm was inversely associated with events (HR=0.64, confidence limits 0.42 to 0.98; P = 0.04). After considering standard risk factors including brachial systolic pressure, higher central pressure derived using radial artery tonometry and a generalized transfer function was not associated with higher CVD risk.

Open Access

This is an open access article distributed under the CC BY-NC license.

TY  - JOUR
AU  - G.F. Mitchell
AU  - S.-J. Hwang
AU  - M.J. Larson
AU  - N.M. Hamburg
AU  - E.J. Benjamin
AU  - R.S. Vasan
AU  - D. Levy
AU  - J.A. Vita
PY  - 2013
DA  - 2013/11/11
TI  - 2.2 TRANSFER FUNCTION-DERIVED CENTRAL PRESSURE AND CARDIOVASCULAR EVENTS: THE FRAMINGHAM HEART STUDY
JO  - Artery Research
SP  - 163
EP  - 163
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.008
DO  - 10.1016/j.artres.2013.10.008
ID  - Mitchell2013
ER  -