Compared with brachial blood pressure (BP), central systolic BP (SBP) can provide a better indication of the hemodynamic strain inflicted on target organs, but it is unclear whether this translates into improved cardiovascular risk stratification. We aimed to assess which of central or brachial BP best predicts cardiovascular risk and to identify the central SBP threshold associated with increased risk of future cardiovascular events. This study included 13 461 participants of CARTaGENE with available central BP and follow-up data from administrative databases but without cardiovascular disease or antihypertensive medication. Central BP was estimated by radial artery tonometry, calibrated for brachial SBP and diastolic BP (type I), and a generalized transfer function (SphygmoCor). The outcome was major adverse cardiovascular events. Cox proportional-hazards models, differences in areas under the curves, net reclassification indices, and integrated discrimination indices were calculated. Youden index was used to identify SBP thresholds. Over a median follow-up of 8.75 years, 1327 major adverse cardiovascular events occurred. The differences in areas under the curves, net reclassification indices, and integrated discrimination indices were of 0.2% ([95% CI, 0.1–0.3] P <0.01), 0.11 ([95% CI, 0.03–0.20] P =0.01), and 0.0004 ([95% CI, −0.0001 to 0.0014] P =0.3), all likely not clinically significant. Central and brachial SBPs of 112 mm Hg (95% CI, 111.2–114.1) and 121 mm Hg (95% CI, 120.2–121.9) were identified as optimal BP thresholds. In conclusion, central BP measured with a type I device is statistically but likely not clinically superior to brachial BP in a general population without prior cardiovascular disease. Based on the risk of major adverse cardiovascular events, the optimal type I central SBP appears to be 112 mm Hg.

SummaryObjectiveInterictal [18F]fluorodeoxyglucose–positron emission tomography (FDG‐PET) is used in the presurgical evaluation of patients with drug‐resistant focal epilepsy. We aimed at clarifying its relationships with ictal high‐frequency oscillations (iHFOs) shown to be a relevant marker of the seizure‐onset zone.MethodsWe studied the correlation between FDG‐PET and epileptogenicity maps in an unselected series of 37 successive patients having been explored with stereo‐electroencephalography (SEEG).ResultsAt the group level, we found a significant correlation between iHFOs and FDG‐PET interictal hypometabolism only in cases of temporal lobe epilepsy. This correlation was found with HFOs, and the same comparison between FDG‐PET and ictal SEEG power of lower frequencies during the same epochs did not show the same significance.SignificanceThis finding suggests that interictal FDG‐PET and ictal HFOs may share common underlying pathophysiologic mechanisms of ictogenesis in temporal lobe epilepsy, and combining both features may help to identify the seizure‐onset zone.