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CENTRAL AND BRACHIAL PULSE PRESSURE PREDICTS CARDIOVASCULAR AND RENAL EVENTS IN TREATED HYPERTENSIVE PATIENTS.

OBJECTIVE
Central blood pressure is a stronger predictor of cardiovascular prognosis rather than brachial blood pressure. Reflection wave reaches abdominal aorta sooner than ascending aorta. Thus, the contribution of central pulse pressure (cPP) to renal events may differ from that to cardiovascular events.


DESIGN AND METHOD
The subanalysis of ABC-J II study (Hypertens Res. 2018;41:947-956) was performed. Subjects were 3434 treatedhypertensive patients with mean follow-up of 4.7 years. The contribution of brachial pulse pressure (bPP) and cPP to cardiovascular and renal events were analyzed.


RESULTS
Cox proportional-hazard analysis revealed that sex (p < 0.001), height (p < 0.05), history of cardiovascular diseases (p < 0.001), numbers of antihypertensive drugs (p < 0.05) and cPP (p < 0.05) contributed to cardiovascular events. However, baseline serum creatinine (p < 0.001) and bPP (p < 0.05) were selected as significant predictors of renal events.


CONCLUSIONS
The present findings indicate that cPP and bPP independently contribute to cardiovascular and renal events, and suggest that the diverse results may be attributable to the anatomy that abdominal aorta feeds renal arteries, but thoracic aorta does cerebral and coronary arteries.