Published online before print February 27, 2006, doi: 10.1161/01.HYP.0000209340.33592.50
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(Hypertension. 2006;47:785.)
© 2006 American Heart Association, Inc.
Original Articles |
Brachial Blood Pressure But Not Carotid Arterial Waveforms Predict Cardiovascular Events in Elderly Female Hypertensives
From the Baker Heart Research Institute (A.M.D., B.A.K.); University of Melbourne (C.D.G.); and Second Australian National Blood Pressure Study Group (K.W., Y.-L.L., K.L.B., L.M.H.W., C.M.R., P.R., L.J.B., G.L.R.J., C.I.J., J.J.M., G.J.M., T.O.M., M.J.W.), LaTrobe University (J.D.C.), Melbourne, Victoria, Australia.
Correspondence to Anthony M. Dart, Baker Medical Research Institute, PO Box 6492, St Kilda Rd Central, Melbourne, Victoria, 8008 Australia. E-mail a.dart{at}alfred.org.au
Central arterial waveforms and related indices of large artery properties can be determined with relative ease. This would make them an attractive adjunct in the risk stratification for cardiovascular disease. Although they have been associated with some classical risk factors and the presence of coronary disease, their prospective value in predicting cardiovascular outcomes is unknown. The present study determined the relative predictive value for cardiovascular disease-free survival of large artery properties as compared with noninvasive brachial blood pressure alone in a population of elderly female hypertensive subjects. We measured systemic arterial compliance, central systolic pressure, and carotid augmentation index in a subset of female participants in the Second Australian National Blood Pressure Study (untreated blood pressure 169/88±12/8 mm Hg). There were a total of 53 defined events during a median of 4.1 years of follow-up in 484 women with complete measurements. Although baseline blood pressures at the brachial artery predicted cardiovascular disease-free survival (hazard ratio [HR], 2.3; 95% CI, 1.3 to 4.1 for pulse pressure 
81 versus <81 mm Hg; P=0.01), no such relation was found for carotid augmentation index (HR, 0.80; 95% CI, 0.44 to 1.44; P value not significant) or systemic arterial compliance (HR, 1.25; 95% CI, 0.72 to 2.16; P value not significant). Blood pressure, but not noninvasively measured central arterial waveforms, predict outcome in the older female hypertensive patient. Thus, blood pressure measurement alone is superior to measurement of arterial waveforms in predicting outcome in this group.
Key Words: blood pressure • elderly • risk factors • gender
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