Inuzuka Sayuri, Correia Mikaelle Costa, Costa Matheus Martins da, Costa Thiago Oliveira, Vitorino Priscila Valverde de Oliveria, Piza Polyana Vulcano de Toledo, Frigieri Gustavo, Sousa Ana Luiza Lima, Coca Antonio, Barroso Weimar Kunz Sebba
Unidade de Hipertensão Arterial - Universidade Federal de Goiás, Goiânia, GO - Brasil.
Pontifícia Universidade Católica de Goiás - Escola de Ciências Sociais e da Saúde, Goiânia, GO - Brasil.
Arq Bras Cardiol. 2025 Apr;122(5):e20240778. doi: 10.36660/abc.20240778.
There is a strong association between hypertension and cerebrovascular disease, mainly with stroke and cognitive impairment. However, but the mechanistic of this relationship are not completely understood.
To analyze the relationship of central, peripheral blood pressure (BP) and arterial stiffness, with intracranial pressure (ICP) in long-term chronic hypertensive patients.
Adult individuals were consecutively included in the study from November 2022 to August 2023. The cut-off point identified to define intracranial hypertension (ICHT) by the wave peak (P2/P1) ratio was > 1.2, and the cut-off for time to peak (TTP) was > 0.25. The level of significance adopted in the statistical analysis was 5%.
A total of 145 patients (32 male, 113 female) with long-term hypertension (average of time since diagnoses 20 ± 12 years) were evaluated over a period of 10 months. The median age was 69.0 (61.8 - 75.7) years and median body mass index 29.0 (25.4 - 33.1) kg/m2. Median value of P2/P1 ratio for all cohort was 1.4 (1.2 - 1.5) and TTP 0.24 (0.21 - 0.29). The analysis was performed considering presence or not of ICHT, and parameters of central BP and pulse wave velocity. There was higher central systolic (SBP), diastolic blood pressure (DBP), and peripheral DBP among patients with ICHT based on the P2/P1 ratio.
Central SBP levels are more linked to ICHT than office peripheral SBP measurements, while DBP measurements are similar, raising questions about the most suitable BP assessment method for hypertensive patients with cerebrovascular damage.
高血压与脑血管疾病之间存在密切关联，主要与中风和认知障碍有关。然而，这种关系的机制尚未完全明了。
分析长期慢性高血压患者的中心血压、外周血压（BP）和动脉僵硬度与颅内压（ICP）之间的关系。
2022年11月至2023年8月，成年个体连续纳入本研究。通过波峰（P2/P1）比值确定的定义颅内高压（ICHT）的截断点>1.2，峰值时间（TTP）的截断值>0.25。统计分析采用的显著性水平为5%。
在10个月的时间里，共评估了145例长期高血压患者（男性32例，女性113例）（诊断后平均时间为20±12年）。中位年龄为69.0（61.8 - 75.7）岁，中位体重指数为29.0（25.4 - 33.1）kg/m²。所有队列的P2/P1比值中位数为1.4（1.2 - 1.5），TTP为0.24（0.21 - 0.29）。根据是否存在ICHT以及中心血压和脉搏波速度参数进行分析。基于P2/P1比值的ICHT患者的中心收缩压（SBP）、舒张压（DBP）和外周DBP较高。
中心SBP水平比诊室外周SBP测量值与ICHT的关联更强，而DBP测量值相似，这引发了对于脑血管损伤高血压患者最合适的血压评估方法的质疑。
