Clinical Study On The 24-h Central Blood Pressure Monitoring

Objective: Advanced technology made it possible to simultaneously monitor the 24-h peripheral and central blood pressures(BP)and arterial function.However,research data on the 24-h central BP monitoring is limited,and there is still uncertainty about its short-term reproducibility and clinical value.Methods: Untreated patients referred for the 24-h ambulatory BP monitoring to the Hypertension Outpatient Department of Ruijin Hospital were invited to participate in the study.Ambulatory BP monitoring was performed with the German Mobil-OGraph monitors.Short-term reproducibility of the 24-h BP and arterial parameters repeated within one month were analyzed.Multiple linear regression models were used to compare the relationship of target organ damage with the 24-h brachial and central BPs and their variability.Results: In 152 patients,for the repeated ambulatory BP and aortic pulse wave velocity measurements,the intra-class correlation coefficients were all ≥0.70,and the coefficient of variation(CV)ranged from 5.0% to 10.3%.For augmentation pressure and index,CV ranged from 15.5% to 22.3%.Repeatability coefficient(RC)expressed as percentages of maximal variation ranged from 25.5% to 54.7% for BP and augmentation indices,and <15% for pulse wave velocity measurements.In 587 participants,Both the brachial and central systolic BPs were significantly(P≤0.01)and similarly(P≥0.55)correlated to pulse wave velocity(partial r,0.32 vs.0.29),log–transformed albumin-to-creatinine ratio(0.19 vs.0.18),and carotid intima-media thickness(0.18 vs.0.15).There was no significant association of target organ measures with any BP variability indices after the adjustment for the 24–h BP level(P≥0.051).Conclusions: The BP and arterial parameters derived from the 24-h central BP monitoring had moderate to good short-term reproducibility.Both brachial and central BPs,other than BP variability,were associated with target organ damage in a similar strength.