Kwon Ami, Kim Gee-Hee, Kim Min-Sik
Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Front Cardiovasc Med. 2022 Aug 11;9:906021. doi: 10.3389/fcvm.2022.906021. eCollection 2022.
Central aortic systolic blood pressure (CBP) measured by carotid-femoral pulse wave analysis (cfPWA) is a gold standard method to estimate true arterial pressure. However, the impact of the CBP level measured by radial PWA on cardiovascular (CV) risk assessment is unclear. This study aimed to determine the impact on CV outcome assessment and the association between the optimal levels of non-invasively measured CBP and automated office blood pressure (OBP) in clinical practice.
A total of 2,115 patients underwent non-invasive semiautomated radial artery applanation tonometry (Omron HEM-9000AI) in the Department of Internal Medicine, St. Vincent's Hospital, from July 2011 to December 2015. The patients were followed for at least 5 years, and atherosclerotic cardiovascular (ASCVD) outcomes were collected.
Among 2,115 patients (mean age 58 ± 14 years, 50.4% men) who were followed up, the median follow-up period was 52 months (range: 1-104 months). The total number of patients with ASCVD events was 163 (7.70%). In multivariate Cox regression analysis, a CBP of more than 125 mmHg and an automated OBP of more than 131 mmHg were independently associated with a significant increase in ASCVD outcomes. After adjusting for confounding factors, the hazard ratio for ASCVD events increased by 12.5, 11.7, and 12.7%, for every 10 mmHg increase in automated OBP, CBP, and central pulse pressure (PP), respectively.
This study demonstrated that the automated OBP measured using the method used in real clinical practice and CBP measured by radial tonometry were associated with an increased risk for adverse ASCVD outcomes.
通过颈股脉搏波分析（cfPWA）测量的中心主动脉收缩压（CBP）是估计真实动脉压的金标准方法。然而，通过桡动脉脉搏波分析（PWA）测量的CBP水平对心血管（CV）风险评估的影响尚不清楚。本研究旨在确定其对CV结局评估的影响，以及在临床实践中无创测量的CBP最佳水平与自动诊室血压（OBP）之间的关联。
2011年7月至2015年12月期间，共有2115例患者在圣文森特医院内科接受了无创半自动桡动脉压平式眼压测量（欧姆龙HEM-9000AI）。对患者进行了至少5年的随访，并收集了动脉粥样硬化性心血管（ASCVD）结局。
在随访的2115例患者（平均年龄58±14岁，男性占50.4%）中，中位随访期为52个月（范围：1-104个月）。发生ASCVD事件的患者总数为163例（7.70%）。在多变量Cox回归分析中，CBP超过125 mmHg和自动OBP超过131 mmHg与ASCVD结局的显著增加独立相关。在调整混杂因素后，自动OBP、CBP和中心脉压（PP）每升高10 mmHg，ASCVD事件的风险比分别增加12.5%、11.7%和12.7%。
本研究表明，在实际临床实践中使用的方法测量的自动OBP和通过桡动脉压平式眼压测量的CBP与不良ASCVD结局风险增加相关。
