Does Measurement of Central Blood Pressure have Treatment Consequences in the Clinical Praxis?

Mitchell, Gary F.

doi:10.1007/s11906-015-0573-x

Cited by 14 publications

(12 citation statements)

References 59 publications

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“…3,4 A VOP, um marcador de dano vascular utilizado na avaliação de rigidez arterial, é considerada um forte marcador independente de LOA e eventos adversos. 5 A VOP também é um preditor de mortalidade por todas as causas, indicando o risco real do paciente. 6 O aumento de um metro por segundo (1m/s) na VOP leva a um aumento de 14% no risco de eventos adversos e de 15% no risco cardiovascular e mortalidade por todas as causas.…”

Section: Introductionunclassified

“…PWV, a vascular damage biomarker used to assess arterial stiffness, is considered a strong and independent marker of TOD and adverse events. 5 PWV is also a predictor of all-cause mortality, indicating the patient’s actual risk. 6 Each one meter per second rise in PWV leads to an increases by 14% in the risk of adverse events and by 15% in the cardiovascular risk and all-cause mortality.…”

Section: Introductionmentioning

confidence: 99%

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Relação entre Velocidade de Onda de Pulso e Biomarcadores Cardiovasculares em Pacientes com Fatores de Risco

Fagundes

Vitorino

Lelis

et al. 2020

Arquivos Brasileiros De Cardiologia

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Fundamento: A relação entre velocidade de onda de pulso (VOP) e biomarcadores de mudanças estruturais do ventrículo esquerdo e artérias carótidas ainda é pouco elucidada. Objetivo: Investigar a relação entre VOP e esses biomarcadores. Métodos: Estudo transversal, retrospectivo e analítico. Revisamos prontuários médicos de pacientes com diabetes mellitus, dislipidemia, e pré-hipertensão ou hipertensão, que realizaram medida de pressão arterial central (PAC) utilizando o Mobil-O-Graph®, e doppler de carótida ou ecocardiografia três meses antes ou após a medida da PAC. Análise estatística realizada por correlação de Pearson ou de Spearman, análise de regressão múltipla e de regressão bivariada, e teste t (independente) ou de Mann-Whitney. Um p<0,05 indicou significância estatística. Resultados: Prontuários de 355 pacientes foram avaliados, 56,1 ±14,8 anos, 51% homens. A VOP correlacionou-se com espessuras da íntima média (EIM) das carótidas (r=0,310) do septo do ventrículo esquerdo (r=0,191) e da parede posterior do ventrículo esquerdo (r=0.215), e com diâmetro do átrio esquerdo (r=0,181). A EIM associou-se com VOP ajustada por idade e pressão sistólica periférica (p=0,0004); uma EIM maior que 1mm aumentou em 3,94 vezes a chance de se apresentar VOP acima de 10m/s. A VOP foi significativamente maior em indivíduos com hipertrofia do ventrículo esquerdo (p=0,0001), EIM > 1 mm (p=0,006), placa de carótida (p=0,0001), estenose ≥ 50% (p=0,003), e lesões de órgãos-alvo (p=0,0001). Conclusões: A VOP correlacionou-se com a EIM e com parâmetros ecocardiográficos, e se associou independentemente com EIM. Essa associação foi mais forte em pacientes com hipertrofia do ventrículo esquerdo, EIM aumentada, placa de carótida, estenose ≥ 50%, e lesões de órgãos-alvo.

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Section: Introductionunclassified

Section: Introductionmentioning

confidence: 99%

Relação entre Velocidade de Onda de Pulso e Biomarcadores Cardiovasculares em Pacientes com Fatores de Risco

Fagundes

Vitorino

Lelis

et al. 2020

Arquivos Brasileiros De Cardiologia

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“…The value of considering cSBP apart from pSBP has been discussed and considered over the last two decades. It has been stated that their association a-priori limits the incremental clinical value of cSBP[32]. However, it has been demonstrated that the association could be modified by the measurement procedure and particularly by the calibration method[8,27,28,33].…”

Section: Discussionmentioning

confidence: 99%

Aortic pressure and forward and backward wave components in children, adolescents and young-adults: Agreement between brachial oscillometry, radial and carotid tonometry data and analysis of factors associated with their differences

et al. 2019

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Non-invasive devices used to estimate central (aortic) systolic pressure (cSBP), pulse pressure (cPP) and forward (Pf) and backward (Pb) wave components from blood pressure (BP) or surrogate signals differ in arteries studied, techniques, data-analysis algorithms and/or calibration schemes (e.g. calibrating to calculated [MBPc] or measured [MBPosc] mean pressure). The aims were to analyze, in children, adolescents and young-adults (1) the agreement between cSBP, cPP, Pf and Pb obtained using carotid (CT) and radial tonometry (RT) and brachial-oscillometry (BOSC); and (2) explanatory factors for the differences between approaches-data and between MBPosc and MBPc.1685 subjects (mean/range age: 14/3-35 y.o.) assigned to three age-related groups (3–12; 12–18; 18–35 y.o.) were included. cSBP, cPP, Pf and Pb were assessed with BOSC (Mobil-O-Graph), CT and RT (SphygmoCor) records. Two calibration schemes were considered: MBPc and MBPosc for calibrations to similar BP levels. Correlation, Bland-Altman tests and multiple regression models were applied. Systematic and proportional errors were observed; errors´ statistical significance and values varied depending on the parameter analyzed, methods compared and group considered. The explanatory factors for the differences between data obtained from the different approaches varied depending on the methods compared. The highest cSBP and cPP were obtained from CT; the lowest from RT. Independently of the technique, parameter or age-group, higher values were obtained calibrating to MBPosc. Age, sex, heart rate, diastolic BP, body weight or height were explanatory factors for the differences in cSBP, cPP, Pf or Pb. Brachial BP levels were explanatory factors for the differences between MBPosc and MBPc.

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“…Wave reflection amplifies the original forward wave amplitude at or near the peripheral reflection site and therefore is a major determinant of PP and SBP . With increasing arterial stiffening, the reflected waves will return to the central aorta earlier and augment central PP and SBP . Increased wave reflection contributes to the development of hypertension and increases cardiovascular risk independently of arterial stiffness .…”

Section: Discussionmentioning

confidence: 99%

Abnormal Pulsatile Hemodynamics in Hypertensive Patients With Normalized 24‐Hour Ambulatory Blood Pressure by Combination Therapy of Three or More Antihypertensive Agents

Sung

et al. 2015

J of Clinical Hypertension

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It remains uncertain whether intensive antihypertensive therapy can normalize pulsatile hemodynamics resulting in minimized residual cardiovascular risks. In this study, office and 24-hour ambulatory systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, carotid-femoral pulse wave velocity (PWV), and forward (Pf) and reflected (Pb) pressure wave from a decomposed carotid pressure wave were measured in hypertensive participants. Among them, 57 patients whose 24-hour SBP and DBP were normalized by three or more classes of antihypertensive medications were included. Another 57 age-and sex-matched normotensive participants were randomly selected from a community survey. The well-treated hypertensive patients had similar 24-hour SBP, lower DBP, and higher PP values. The treated patients had higher PWV (11.7AE0.3 vs 8.3AE0.2 m/s, P<.001), Pf, Pb, Pb/Pf, and left ventricular mass index values. After adjustment for age, sex, body mass index, and office SBP, the differences for PWV, Pb, and Pb/Pf remained significant. Hypertensive patients whose 24-hour SBP and DBP are normalized may still have markedly increased arterial stiffness and wave reflection.

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Does Measurement of Central Blood Pressure have Treatment Consequences in the Clinical Praxis?

Cited by 14 publications

References 59 publications

Relação entre Velocidade de Onda de Pulso e Biomarcadores Cardiovasculares em Pacientes com Fatores de Risco

Relação entre Velocidade de Onda de Pulso e Biomarcadores Cardiovasculares em Pacientes com Fatores de Risco

Aortic pressure and forward and backward wave components in children, adolescents and young-adults: Agreement between brachial oscillometry, radial and carotid tonometry data and analysis of factors associated with their differences

Abnormal Pulsatile Hemodynamics in Hypertensive Patients With Normalized 24‐Hour Ambulatory Blood Pressure by Combination Therapy of Three or More Antihypertensive Agents

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