Association of central and peripheral blood pressures with intermediate cardiovascular phenotypes.

In conclusion, numerous studies have documented a superior relation of central over brachial BP to intermediate cardiovascular phenotypes or cardiovascular target organ damage. In general, PP has been more strongly related to vascular disease, whereas systolic pressure seems to be a more important determinant of LVH. The similarity of findings in a wide variety of patient-based and population-based studies as well as a broad range of ethnicities supports the robust nature of this phenomenon. Although data regarding the superiority of central over brachial PP with regard to LV diastolic dysfunction are preliminary, the importance of LVH, female sex, and aging as underlying risk factors for HFPEF suggests that more extensive evaluation is likely to reveal a stronger relation of central than peripheral BP with this additional measure of target organ involvement. Finally, limited data suggesting a more important impact of reversing hypertensive cardiovascular hypertrophy by lowering central pressure for a given brachial pressure require confirmation in larger, longitudinal intervention studies.