Published online before print July 23, 2007, doi: 10.1161/HYPERTENSIONAHA.107.095752
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(Hypertension. 2007;50:e64.)
© 2007 American Heart Association, Inc.
Letters to the Editor |
Response to Effects of Angiotensin-Converting Enzyme Inhibitors on Central Blood Pressure
Baker Heart Research Institute, Melbourne, Australia
La Trobe University, Melbourne, Australia
University of Melbourne, Melbourne, Australia
Baker Heart Research Institute, Melbourne, Australia
For reasons we do not understand Dr O’Rourke and colleagues1 refer in their correspondence to a study of a device we did not use (a Dinamap 845).2 We would refer Dr O’Rourke and colleagues to a 1998 study3 involving 120 subjects and the more relevant Dinamap 1846, which showed a mean difference (overestimation/underestimation) from the directly measured intra-aortic pressure of approximately –1mm Hg for mean arterial and of approximately +3 mm Hg for diastolic blood pressure. The study of Beaubien et al quoted in their letter4 does not in fact assess the performance of the Dinamap against the variable of interest, namely the directly recorded intra-arterial pressure, but against the pressure determined from a mercury sphygmomanometer applied to the brachial artery. It is curious that our previous findings5 are referred to as "paradoxical" unless Dr O’Rourke and colleagues have some preconception of what the results of a study should be. With regard to the quoted study of Jiang et al,6 which used a generalized transfer function method of estimating central blood pressure, it is of note that the mean age of these mildly hypertensive subjects was 52 years. The studies we report involved subjects with established hypertension followed for up to 6 years and whose mean age at the start of the study was 72. We would not find it surprising if the arterial properties under investigation showed significant changes over 20 years.
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Acknowledgments |
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Disclosures
None.
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References |
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 Top References |
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1. O’Rourke MF, Nichols WW, Safar ME. Effects of angiotensin-converting enzyme inhibitors on central blood pressure. Hypertension. 2007; 50: e63.
2. Borow KM, Newburger JW. Noninvasive estimation of central aortic pressure using the oscillometric method for analyzing systemic artery pulsatile blood flow: comparative study of indirect systolic, diastolic, and mean brachial artery pressure with simultaneous direct ascending aortic pressure measurements. Am Heart J. 1982; 103: 879–886.[CrossRef][Medline] [Order article via Infotrieve]
3. Lehmann KG, Gelman JA, Weber MA, Lafrades A. Comparative accuracy of three automated techniques in the noninvasive estimation of central blood pressure in men. Am J Cardiol. 1998; 81: 1004–1012.[CrossRef][Medline] [Order article via Infotrieve]
4. Beaubien ER, Card CM, Card SE, Biem HJ, Wilson TW. Accuracy of the Dinamap 1846 XT automated blood pressure monitor. J Hum Hypertens. 2002; 16: 647–652.[CrossRef][Medline] [Order article via Infotrieve]
5. Dart AM, Gatzka CD, Kingwell BA, Willson K, Cameron JD, Liang YL, Berry KL, Wing LM, Reid CM, Ryan P, Beilin LJ, Jennings GL, Johnston CI, McNeil JJ, Macdonald GJ, Morgan TO, West MJ. Brachial blood pressure but not carotid arterial waveforms predict cardiovascular events in elderly female hypertensives. Hypertension. 2006; 47: 785–790.
6. Jiang XJ, O’Rourke MF, Zhang YQ, He XY, Liu LS. Superior effect of an angiotensin-converting enzyme inhibitor over a diuretic for reducing aortic systolic pressure. J Hypertens. 2007; 25: 1095–1099.[Medline] [Order article via Infotrieve]
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