Transfer function-derived central pressure and cardiovascular disease events: The Framingham Heart Study

Gary F. Mitchell, Shih Jen Hwang, Martin G. Larson, Naomi M. Hamburg, Emelia J. Benjamin, Ramachandran S. Vasan, Daniel Levy, Joseph A. Vita

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1528-1534
Number of pages7
JournalJournal of Hypertension
Volume34
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

Keywords

  • aorta
  • augmentation index
  • cardiovascular disease
  • central pressure
  • prognosis
  • reflected wave

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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