Progression in Central Blood Pressure and Hemodynamic Parameters and Relationship With Cardiovascular Risk Factors in a Spanish Population: EVA Follow-Up Study

Background: The progression of central blood pressure (CBP) values and central hemodynamic parameters and its relationship with cardiovascular risk factors is quite unknown. We sought to investigate this association in a Spanish adult population without cardiovascular diseases.

Methods: Prospective observational research with a 5-year follow-up. Randomly sampled 501 individuals (mean age 56 ± 14 years, 50.3% women). After 5 years, 480 individuals had a follow-up. Measurements taken using the SphygmoCor (AtCor Medical Pty Ltd., Head Office, West Ryde, Australia), following all the recommendations established in the "International task force" (Sharman JE, Avolio AP, Baulmann J, Benetos A, Blacher J, Blizzard CL, Boutouyrie P, Chen CH, Chowienczyk P, Cockcroft JR, Cruickshank JK, Ferreira I, Ghiadoni L, Hughes A, Jankowski P, Laurent S, McDonnell BJ, McEniery C, Millasseau SC, Papaioannou TG, Vlachopoulos C. Validation of non-invasive central blood pressure devices: ARTERY Society task force consensus statement on protocol standardization. Eur Heart J 2017; 38:2805-2812), giving an estimate of CBP relative to measured brachial blood pressure (type 1 device).

Results: Progressions during follow-up: central systolic blood pressure (cSBP): 4.16 ± 13.71 mm Hg; central diastolic blood pressure: 2.45 ± 11.37 mm Hg; central pulse pressure: 1.72 ± 12.43 mm Hg; pulse pressure amplification (PPA): 2.85 ± 12.20 mm Hg; ejection duration: 7.00 ± 47.87 ms; subendocardial viability ratio (SEVR): -8.04 ± 36.24%. In multiple regression analysis: cSBP positively associated with: body mass index (BMI) (β = 0.476); waist size (β = 0.159); number of cigarettes per day (β = 0.192). Inversely associated with peripheral systolic blood pressure (β = -0.282). Central diastolic blood pressure increase positively associated with number of cigarettes per day (β = 0.174). Inversely associated with peripheral diastolic blood pressure (β = -0.292). Central pulse pressure increase positively associated with BMI (β = 0.330). Inversely associated with peripheral pulse pressure (β = -0.262). Pulse pressure amplification increase positively associated with: BMI (β = 0.276); number of cigarettes per day (β = 0.281). Ejection duration progress inversely associated with basal plasma glucose (β = -0.286).

Conclusions: All measures increased except for SEVR. Progressions in CBP and PPA were positively associated with anthropometric parameters and number of cigarettes and CBP inversely associated with peripheral blood pressure, although this association was different according to sex.