TY - JOUR
T1 - Twenty-Four-Hour Central (Aortic) Systolic Blood Pressure: Reference Values and Dipping Patterns in Untreated Individuals
AU - Weber, Thomas
AU - Protogerou, Athanase D.
AU - Agharazii, Mohsen
AU - Argyris, A.
AU - Bahous, Sola Aoun
AU - Banegas, Jose R.
AU - Binder, R.K.
AU - Blacher, Jacques
AU - Brandao, Andréa Araujo
AU - Cruz, Juan J
AU - Danninger, Kathrin
AU - Giannatasio, Cristina
AU - Graciani, Auxiliadora
AU - Hametner, Bernhard
AU - Jankowski, Piotr
AU - Li, J.
AU - Maloberti, A.
AU - Mayer, Christopher Clemens
AU - McDonnell, Barry J.
AU - McEniery, C.
AU - Mota, Marco
AU - Gomes, Annelise Machado
AU - Muiesan, Maria Lorenza
AU - Nemcsik, J.
AU - Paini, Anna
AU - Rodilla, Enrique
AU - Schutte, Aletta E
AU - Sfikakis, Petros P
AU - Terentes-Printzios, Dimitrios
AU - Valleé, Alexandre
AU - Vlachopoulos, Charalambos
AU - Ware, Lisa
AU - Wilkinson, Ian
AU - Zweiker, Robert
AU - Sharman, James E.
AU - Wassertheurer, Siegfried
PY - 2022
Y1 - 2022
N2 - Central (aortic) systolic blood pressure (cSBP) is the pressure seen by the heart, the brain, and the kidneys. If properly measured, cSBP is closer associated with hypertension-mediated organ damage and prognosis, as compared with brachial SBP (bSBP). We investigated 24-hour profiles of bSBP and cSBP, measured simultaneously using Mobilograph devices, in 2423 untreated adults (1275 women; age, 1894 years), free from overt cardiovascular disease, aiming to develop reference values and to analyze daytime-nighttime variability. Central SBP was assessed, using brachial waveforms, calibrated with mean arterial pressure (MAP)/diastolic BP (cSBPMAP/DBPcal), or bSBP/diastolic blood pressure (cSBPSBP/DBPcal), and a validated transfer function, resulting in 144 509 valid brachial and 130 804 valid central measurements. Averaged 24-hour, daytime, and nighttime brachial BP across all individuals was 124/79, 126/81, and 116/72 mm Hg, respectively. Averaged 24-hour, daytime, and nighttime values for cSBPMAP/DBPcal were 128, 128, and 125 mm Hg and 115, 117, and 107 mm Hg for cSBPSBP/DBPcal, respectively. We pragmatically propose as upper normal limit for 24-hour cSBPMAP/DBPcal 135 mm Hg and for 24-hour cSBPSBP/DBPcal 120 mm Hg. bSBP dipping (nighttime-daytime/daytime SBP) was −10.6 % in young participants and decreased with increasing age. Central SBPSBP/DBPcal dipping was less pronounced (−8.7% in young participants). In contrast, cSBPMAP/DBPcal dipping was completely absent in the youngest age group and less pronounced in all other participants. These data may serve for comparison in various diseases and have potential implications for refining hypertension diagnosis and management. The different dipping behavior of bSBP versus cSBP requires further investigation.
AB - Central (aortic) systolic blood pressure (cSBP) is the pressure seen by the heart, the brain, and the kidneys. If properly measured, cSBP is closer associated with hypertension-mediated organ damage and prognosis, as compared with brachial SBP (bSBP). We investigated 24-hour profiles of bSBP and cSBP, measured simultaneously using Mobilograph devices, in 2423 untreated adults (1275 women; age, 1894 years), free from overt cardiovascular disease, aiming to develop reference values and to analyze daytime-nighttime variability. Central SBP was assessed, using brachial waveforms, calibrated with mean arterial pressure (MAP)/diastolic BP (cSBPMAP/DBPcal), or bSBP/diastolic blood pressure (cSBPSBP/DBPcal), and a validated transfer function, resulting in 144 509 valid brachial and 130 804 valid central measurements. Averaged 24-hour, daytime, and nighttime brachial BP across all individuals was 124/79, 126/81, and 116/72 mm Hg, respectively. Averaged 24-hour, daytime, and nighttime values for cSBPMAP/DBPcal were 128, 128, and 125 mm Hg and 115, 117, and 107 mm Hg for cSBPSBP/DBPcal, respectively. We pragmatically propose as upper normal limit for 24-hour cSBPMAP/DBPcal 135 mm Hg and for 24-hour cSBPSBP/DBPcal 120 mm Hg. bSBP dipping (nighttime-daytime/daytime SBP) was −10.6 % in young participants and decreased with increasing age. Central SBPSBP/DBPcal dipping was less pronounced (−8.7% in young participants). In contrast, cSBPMAP/DBPcal dipping was completely absent in the youngest age group and less pronounced in all other participants. These data may serve for comparison in various diseases and have potential implications for refining hypertension diagnosis and management. The different dipping behavior of bSBP versus cSBP requires further investigation.
KW - arterial pressure
KW - blood pressure
KW - heart rate
KW - hypertension
KW - arterial pressure
KW - blood pressure
KW - heart rate
KW - hypertension
U2 - 10.1161/HYPERTENSIONAHA.121.17765
DO - 10.1161/HYPERTENSIONAHA.121.17765
M3 - Article
SN - 0194-911X
SP - 251
EP - 260
JO - Hypertension
JF - Hypertension
ER -