Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography
Abstract The clinical significance of central beyond brachial blood pressure (BP) remains unclear. In patients who underwent coronary angiography, the authors explored whether elevated central BP would be associated with coronary arterial disease (CAD) irrespective of the status of brachial hyperten...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-07-01
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| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.14691 |
| _version_ | 1797645152631652352 |
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| author | Yu Chen Ming‐Xuan Li Ying Wang Xian Jin Liang Liu Zhen‐Fa Zhou Feng‐Hua Ding Rui‐Yan Zhang Yan Li Cheng‐Xing Shen |
| author_facet | Yu Chen Ming‐Xuan Li Ying Wang Xian Jin Liang Liu Zhen‐Fa Zhou Feng‐Hua Ding Rui‐Yan Zhang Yan Li Cheng‐Xing Shen |
| author_sort | Yu Chen |
| collection | DOAJ |
| description | Abstract The clinical significance of central beyond brachial blood pressure (BP) remains unclear. In patients who underwent coronary angiography, the authors explored whether elevated central BP would be associated with coronary arterial disease (CAD) irrespective of the status of brachial hypertension. From March 2021 to April 2022, 335 patients (mean age 64.9 years, 69.9% men) hospitalized for suspected CAD or unstable angina were screened in an ongoing trial. CAD was defined if a coronary stenosis of ≥50%. According to the presence of brachial (non‐invasive cuff systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) and central (invasive systolic BP ≥130 mmHg) hypertension, patients were cross‐classified as isolated brachial hypertension (n = 23), isolated central hypertension (n = 93), and concordant normotension (n = 100) or hypertension (n = 119). In continuous analyses, both brachial and central systolic BPs were significantly related to CAD with similar standardized odds ratios (OR, 1.47 and 1.45, p < .05). While categorical analyses showed that patients with isolated central hypertension or concordant hypertension had a significantly higher prevalence of CAD and the Gensini score than those with concordant normotension. Multivariate‐adjusted OR (95% confidence interval [CI]) for CAD was 2.24 (1.16 to 4.33, p = .009) for isolated central hypertension and 3.02 (1.58 to 5.78, p < .001) for concordant hypertension relative to concordant normotension. The corresponding OR (95% CI) of a high Gensini score was 2.40 (1.26–4.58) and 2.17 (1.19–3.96), respectively. In conclusion, regardless of the presence of brachial hypertension, elevated central BP was associated with the presence and severity of CAD, indicating that central hypertension is an important risk factor for coronary atherosclerosis. |
| first_indexed | 2024-03-11T14:43:11Z |
| format | Article |
| id | doaj.art-417a0aad89864f2886c49de5e746f5e2 |
| institution | Directory Open Access Journal |
| issn | 1524-6175 1751-7176 |
| language | English |
| last_indexed | 2024-03-11T14:43:11Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj.art-417a0aad89864f2886c49de5e746f5e22023-10-30T13:26:37ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762023-07-0125761061710.1111/jch.14691Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiographyYu Chen0Ming‐Xuan Li1Ying Wang2Xian Jin3Liang Liu4Zhen‐Fa Zhou5Feng‐Hua Ding6Rui‐Yan Zhang7Yan Li8Cheng‐Xing Shen9Department of Cardiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital ShanghaiChinaDepartment of Cardiovascular Medicine Shanghai Institute of Hypertension Shanghai Key Laboratory of Hypertension National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiatong University School of Medicine ShanghaiChinaDepartment of Cardiovascular Medicine Shanghai Institute of Hypertension Shanghai Key Laboratory of Hypertension National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiatong University School of Medicine ShanghaiChinaDepartment of Cardiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital ShanghaiChinaDepartment of Cardiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital ShanghaiChinaDepartment of Cardiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital ShanghaiChinaDepartment of Cardiovascular Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine ShanghaiChinaDepartment of Cardiovascular Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine ShanghaiChinaDepartment of Cardiovascular Medicine Shanghai Institute of Hypertension Shanghai Key Laboratory of Hypertension National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiatong University School of Medicine ShanghaiChinaDepartment of Cardiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital ShanghaiChinaAbstract The clinical significance of central beyond brachial blood pressure (BP) remains unclear. In patients who underwent coronary angiography, the authors explored whether elevated central BP would be associated with coronary arterial disease (CAD) irrespective of the status of brachial hypertension. From March 2021 to April 2022, 335 patients (mean age 64.9 years, 69.9% men) hospitalized for suspected CAD or unstable angina were screened in an ongoing trial. CAD was defined if a coronary stenosis of ≥50%. According to the presence of brachial (non‐invasive cuff systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) and central (invasive systolic BP ≥130 mmHg) hypertension, patients were cross‐classified as isolated brachial hypertension (n = 23), isolated central hypertension (n = 93), and concordant normotension (n = 100) or hypertension (n = 119). In continuous analyses, both brachial and central systolic BPs were significantly related to CAD with similar standardized odds ratios (OR, 1.47 and 1.45, p < .05). While categorical analyses showed that patients with isolated central hypertension or concordant hypertension had a significantly higher prevalence of CAD and the Gensini score than those with concordant normotension. Multivariate‐adjusted OR (95% confidence interval [CI]) for CAD was 2.24 (1.16 to 4.33, p = .009) for isolated central hypertension and 3.02 (1.58 to 5.78, p < .001) for concordant hypertension relative to concordant normotension. The corresponding OR (95% CI) of a high Gensini score was 2.40 (1.26–4.58) and 2.17 (1.19–3.96), respectively. In conclusion, regardless of the presence of brachial hypertension, elevated central BP was associated with the presence and severity of CAD, indicating that central hypertension is an important risk factor for coronary atherosclerosis.https://doi.org/10.1111/jch.14691brachial blood pressurecentral blood pressurecoronary artery diseasehypertension |
| spellingShingle | Yu Chen Ming‐Xuan Li Ying Wang Xian Jin Liang Liu Zhen‐Fa Zhou Feng‐Hua Ding Rui‐Yan Zhang Yan Li Cheng‐Xing Shen Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography The Journal of Clinical Hypertension brachial blood pressure central blood pressure coronary artery disease hypertension |
| title | Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography |
| title_full | Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography |
| title_fullStr | Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography |
| title_full_unstemmed | Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography |
| title_short | Brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography |
| title_sort | brachial and central hypertension in relation to coronary stenosis in patients with coronary angiography |
| topic | brachial blood pressure central blood pressure coronary artery disease hypertension |
| url | https://doi.org/10.1111/jch.14691 |
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