Comparison of Prevalent Hypertension by Aortic versus Brachial Blood Pressure Criteria for - A Pulse Wave Analysis Based Study from Adults of a City of West India
Main Article Content
Keywords
Age, Blood Pressure , Correlation, Gender; Hypertension.
Abstract
Background: Disparities exist in aortic blood pressure (aBP) and brachial blood pressure (bBP) and between aortic (AH) versus brachial hypertension (BH). While the former is superior, it is studied scarcely. Pulse wave analysis (PWA) provides objective and simultaneous measurement of both blood pressures to determine AH and BH. Using PWA, we compared prevalent AH and BH in a sample adult population.
Methodology: By oscillometric PWA (Mobilograph, IEM, Stolberg, Germany), 1187 participants with age >18 years were evaluated. Simultaneous aBP and bBP were recorded by standard PWA protocol and prevalence of AH and BH was estimated. Age and gender-based subgroups were compared for aortic versus brachial BP differences. Prevalence of Hypertension, Isolated Systolic Hypertension, and Pulse Pressure ≥40 was compared between aortic versus brachial criteria.
Results: Significant differences were seen between bBP and aBP across all age groups and in both genders, especially for the younger age groups. As compared to bBP, aBP gave a higher fetch for prevalent hypertension and a lower fetch for prevalent Isolated Systolic Hypertension (ISH). bPP ≥40 was sensitive but not specific as a surrogate for aPP ≥ 40.
Conclusions: Across ages 18-65 in either sex, disparities exist between bBP and aBP mostly for SBP and PP with significant differences in prevalent Hypertension, Isolated Systemic Hypertension, and high pulse pressure. It reaffirms disparities of aBP and bBP and diagnosed brachial or central hypertension based on them with the need for further work.
References
2. Murakami T. Central Blood Pressure Estimation. J Atheroscler Thromb 2023:ED229.
3. Solanki JD, Mehta HB, Shah CJ. Aortic pulse wave velocity and augmentation index@75 measured by oscillometric pulse wave analysis in Gujarati nonhypertensive. Vasc Invest Ther 2018; 1:50–5.
4. Park JB, Avolio A. Arteriosclerosis and atherosclerosis assessment in clinical practice: Methods and significance. Pulse 2023; 11(1):1-8.
5. Van der Giet M. How should blood pressure be measured? Con: the peripheral blood pressure is sufficient. Kidney Int 2023; 103(1):38-40.
6. Sharman JE. Value of measuring central blood pressure in clinical practice. Kidney Int 2023; 103(1):34-8.
7. Solanki J, Mehta H, Shah C. Aortic blood pressure and central hemodynamics measured by noninvasive pulse wave analysis in Gujarati normotensives. Int J Clin Exp Physiol 2018; 5(2): 75-80.
8. Solanki JD, Mehta HB, Shah CJ. Oscillometric pulse wave analysis in newly diagnosed never treated Gujarati hypertensives. Vasc Invest Ther 2018; 1:62–7.
9. Walser M, Schlichtiger J, Dalla-Pozza R, Mandilaras G, Tengler A, Ulrich S, et al. Oscillometric pulse wave velocity estimated via the Mobil-O-Graph shows excellent accuracy in children, adolescents, and young adults: an invasive validation study. J Hypertens 2023; 41(4):597-607.
10. Cuspidi C, Tadic M, Grassi G, Mancia G. Treatment of hypertension: The ESH/ESC guidelines recommendations. Pharmacol Res 2018; 128:315-21.
11. Bui TV, Picone DS, Schultz MG, Peng X, Black JA, Dwyer N, et al. Accuracy of cuff blood pressure and systolic blood pressure amplification. Hypertens Res 2023:1-9.
12. FA M. The physiology and clinical use of the sphygmograph. Medical Times Gazette, London. 1872; 1:62-5.
13. Cheng YB, Li Y, Cheng HM, Siddique S, Huynh MV, Sukonthasarn A,et al.Central hypertension is a non‐negligible cardiovascular risk factor. J Clin Hypertens 2022; 24(9):1174-9.
14. Chuang SY, Chang HY, Tsai TY, Cheng HM, Pan WH, Chen CH. Isolated systolic hypertension and central blood pressure: Implications from the national nutrition and health survey in Taiwan. J Clin Hypertens 2021; 23(3):656-64.
15. Adji A, O'Rourke MF. Tracking of brachial and central aortic systolic pressure over the normal human lifespan: insight from the arterial pulse waveforms. Intern Med J 2021; 51(1):13-9.
16. Shiraishi M, Murakami T, Higashi K. The accuracy of central blood pressure obtained by oscillometric noninvasive method using Mobil-O-Graph in children and adolescents. J Hypertens 2020; 38(5):813-20.
17. Schettini IV, Rios DR, Figueiredo RC. Effect of Different Classes of Antihypertensive Drugs on Arterial Stiffness. Curr Hypertens Rep 2023; 25(5):61-70.
18. Yu S, McEniery CM. Central versus peripheral artery stiffening and cardiovascular risk. Arterioscler Thromb Vasc Biol 2020; 40(5):1028-33.
19. Bulas J, Potocarova M, Kupcova V, Gaspar L, Wimmer G, Murin J. Central systolic blood pressure increases with aortic stiffness. Bratisl Lek Listy 2019; 120(12):894-8.
20. Huang J, An D, Cheng Y, Li M, Huang Q, Sheng C, et al.S-37-2: Circadian Rhythm of Peripheral and Central Arterial Blood Pressures in Relation to All-Cause Mortality. J Hypertens 2023; 41(Suppl 1):e83.
21. Sugiura T, Takase H, Machii M, Nonaka D, Ohno K, Ohte N,et al.Central blood pressure predicts the development of hypertension in the general population. Hypertens Res 2020; 43(11):1301-8.
22. Gkaliagkousi E, Protogerou AD, Argyris AA, Koletsos N, Triantafyllou A, Anyfanti P, et al. Contribution of single office aortic systolic blood pressure measurements to the detection of masked hypertension: data from two separate cohorts. Hypertens Res 2021; 44(2):215-24.
23. Tang KS, Medeiros ED, Shah AD. Wide pulse pressure: a clinical review. J Clin Hypertens 2020; 22(11):1960-7.
24. Vasan RS, Song RJ, Xanthakis V, Beiser A, DeCarli C, Mitchell GF, et al.Hypertension-mediated organ damage: prevalence, correlates, and prognosis in the community. Hypertens 2022; 79(3):505-15.
25. Terentes-Printzios D, Gardikioti V, Vlachopoulos C. Central over peripheral blood pressure: an emerging issue in hypertension research. Heart, Lung, and Circ 2021; 30(11):1667-74.
26. Krishnamoorthy Y, Rajaa S, Sulgante S, Chinnakali P, Jaswal N, Goel S. Prevalence of hypertension and determinants of treatment-seeking behaviour among adolescents and young adults in India: an analysis of NFHS-4. J Public Health 2023; 45(1):e48-56.
27. Li Y. S-34-1: Central Hypertension is a Non-Negligible Cardiovascular Risk Factor. J Hypertens 2023; 41(Suppl 1):e77.
28. Floege J. Central blood pressure: nice to know but not yet ready for routine practice. Kidney Int 2023; 103(1):40-1.
29. Satheesh G, Dhurjati R, Balagopalan JP, Mohanan PP, Salam A. Comparison of Indian clinical practice guidelines for the management of hypertension with the World Health Organization, International Society of Hypertension, American, and European guidelines, Indian Heart J 2024;76(1):6-9.
30. Solanki JD, Mehta HB, Shah CJ. Oscillometric pulse wave analysis in newly diagnosed never treated Gujarati hypertensives. Vasc Investig Ther 2018; 1(2):62-7.