TY - JOUR
T1 - Transfer function-derived central pressure and cardiovascular disease events
T2 - The Framingham Heart Study
AU - Mitchell, Gary F.
AU - Hwang, Shih Jen
AU - Larson, Martin G.
AU - Hamburg, Naomi M.
AU - Benjamin, Emelia J.
AU - Vasan, Ramachandran S.
AU - Levy, Daniel
AU - Vita, Joseph A.
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: Relations between central pulse pressure (PP) or pressure amplification and major cardiovascular disease (CVD) events are controversial. Estimates of central aortic pressure derived using radial artery tonometry and a generalized transfer function may better predict CVD risk beyond the predictive value of brachial SBP. Methods: Augmentation index, central SBP, central PP, and central-to-peripheral PP amplification were evaluated using radial artery tonometry and a generalized transfer function as implemented in the SphygmoCor device (AtCor Medical, Itasca, Illinois, USA). We used proportional hazards models to examine relations between central hemodynamics and first-onset major CVD events in 2183 participants (mean age 62 years, 58% women) in the Framingham Heart Study. Results: During median follow-up of 7.8 (limits 0.2-8.9) years, 149 participants (6.8%) had an incident event. Augmentation index (P=0.6), central aortic systolic pressure (P=0.20), central aortic PP (P=0.24), and PP amplification (P=0.15) were not related to CVD events in multivariable models that adjusted for age, sex, brachial cuff systolic pressure, use of antihypertensive therapy, total and high-density lipoprotein cholesterol concentrations, smoking, and presence of diabetes. In a model that included standard risk factors, model fit was improved (P=0.03) when brachial systolic pressure was added after central, whereas model fit was not improved (P=0.30) when central systolic pressure was added after brachial. Conclusion: After considering standard risk factors, including brachial cuff SBP, augmentation index, central PP and PP amplification derived using radial artery tonometry, and a generalized transfer function were not predictive of CVD risk.
AB - Background: Relations between central pulse pressure (PP) or pressure amplification and major cardiovascular disease (CVD) events are controversial. Estimates of central aortic pressure derived using radial artery tonometry and a generalized transfer function may better predict CVD risk beyond the predictive value of brachial SBP. Methods: Augmentation index, central SBP, central PP, and central-to-peripheral PP amplification were evaluated using radial artery tonometry and a generalized transfer function as implemented in the SphygmoCor device (AtCor Medical, Itasca, Illinois, USA). We used proportional hazards models to examine relations between central hemodynamics and first-onset major CVD events in 2183 participants (mean age 62 years, 58% women) in the Framingham Heart Study. Results: During median follow-up of 7.8 (limits 0.2-8.9) years, 149 participants (6.8%) had an incident event. Augmentation index (P=0.6), central aortic systolic pressure (P=0.20), central aortic PP (P=0.24), and PP amplification (P=0.15) were not related to CVD events in multivariable models that adjusted for age, sex, brachial cuff systolic pressure, use of antihypertensive therapy, total and high-density lipoprotein cholesterol concentrations, smoking, and presence of diabetes. In a model that included standard risk factors, model fit was improved (P=0.03) when brachial systolic pressure was added after central, whereas model fit was not improved (P=0.30) when central systolic pressure was added after brachial. Conclusion: After considering standard risk factors, including brachial cuff SBP, augmentation index, central PP and PP amplification derived using radial artery tonometry, and a generalized transfer function were not predictive of CVD risk.
KW - aorta
KW - augmentation index
KW - cardiovascular disease
KW - central pressure
KW - prognosis
KW - reflected wave
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U2 - 10.1097/HJH.0000000000000968
DO - 10.1097/HJH.0000000000000968
M3 - Article
C2 - 27219486
AN - SCOPUS:84969930916
SN - 0263-6352
VL - 34
SP - 1528
EP - 1534
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 8
ER -