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Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors

(2014) EUROPEAN HEART JOURNAL. 35(44). p.3122-3133
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The Asklepios study
Abstract
Aims: Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasivemeasures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different available methods of measurement. How these values were significantly altered by cardiovascular risk factors (CVRFs) was then investigated. Methods and results: Existing data from population surveys and clinical trials were combined, whether published or not. Reference values of cSBP and amplificationwere calculated as percentiles for 'Normal' (no CVRFs) and 'Reference' (any CVRFs) populations. We included 45 436 subjects out of 82 930 that were gathered from 77 studies of 53 centres. Included subjects were apparently healthy, not treated for hypertension or dyslipidaemia, and free from overt CV disease and diabetes. Values of cSBP and amplification were stratified by brachial blood pressure categories and age decade in turn, both being stratified by sex. Amplification decreased with age and more so in males than in females. Sex was the mostpowerful factor associated with amplification with 6.6 mmHg(5.8-7.4) higher amplification in males than in females. Amplification was marginally but significantly influenced by CVRFs, with smoking and dyslipidaemia decreasing amplification, but increased with increasing levels of blood glucose. Conclusion: Typical values of cSBP and amplification in a healthy population and a population free of traditional CVRFs are now available according to age, sex, and brachial BP, providing values included from different devices with a wide geographical representation. Amplification is significantly influenced by CVRFs, but differently in men and women.
Keywords
Aorta, Arteries, Arteriosclerosis, Blood pressure, Central pressure, Humans, Pulse, ISOLATED SYSTOLIC HYPERTENSION, CENTRAL AORTIC PRESSURE, ARTERIAL WAVE REFLECTIONS, PULSE PRESSURE, NONINVASIVE ASSESSMENT, APPLANATION TONOMETRY, CENTRAL HEMODYNAMICS, SPHYGMOCOR DEVICE, UPPER-LIMB, STIFFNESS, Aged, Adult

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Citation

Please use this url to cite or link to this publication:

Chicago
Herbert, Annie, John Kennedy Cruickshank, Stéphane Laurent, Pierre Boutouyrie, on behalf of The Reference Values for Arterial Measurements Collaboration, SEBASTIAN VERMEERSCH, Ernst Rietzschel, et al. 2014. “Establishing Reference Values for Central Blood Pressure and Its Amplification in a General Healthy Population and According to Cardiovascular Risk Factors.” European Heart Journal 35 (44): 3122–3133.
APA
Herbert, A., Cruickshank, J. K., Laurent, S., Boutouyrie, P., The Reference Values for Arterial Measurements Collaboration, on behalf of, VERMEERSCH, S., Rietzschel, E., et al. (2014). Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. EUROPEAN HEART JOURNAL, 35(44), 3122–3133.
Vancouver
1.
Herbert A, Cruickshank JK, Laurent S, Boutouyrie P, The Reference Values for Arterial Measurements Collaboration on behalf of, VERMEERSCH S, et al. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. EUROPEAN HEART JOURNAL. 2014;35(44):3122–33.
MLA
Herbert, Annie, John Kennedy Cruickshank, Stéphane Laurent, et al. “Establishing Reference Values for Central Blood Pressure and Its Amplification in a General Healthy Population and According to Cardiovascular Risk Factors.” EUROPEAN HEART JOURNAL 35.44 (2014): 3122–3133. Print.
@article{6716939,
  abstract     = {Aims: Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasivemeasures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different available methods of measurement. How these values were significantly altered by cardiovascular risk factors (CVRFs) was then investigated. 
Methods and results: Existing data from population surveys and clinical trials were combined, whether published or not. Reference values of cSBP and amplificationwere calculated as percentiles for 'Normal' (no CVRFs) and 'Reference' (any CVRFs) populations. We included 45 436 subjects out of 82 930 that were gathered from 77 studies of 53 centres. Included subjects were apparently healthy, not treated for hypertension or dyslipidaemia, and free from overt CV disease and diabetes. Values of cSBP and amplification were stratified by brachial blood pressure categories and age decade in turn, both being stratified by sex. Amplification decreased with age and more so in males than in females. Sex was the mostpowerful factor associated with amplification with 6.6 mmHg(5.8-7.4) higher amplification in males than in females. Amplification was marginally but significantly influenced by CVRFs, with smoking and dyslipidaemia decreasing amplification, but increased with increasing levels of blood glucose. 
Conclusion: Typical values of cSBP and amplification in a healthy population and a population free of traditional CVRFs are now available according to age, sex, and brachial BP, providing values included from different devices with a wide geographical representation. Amplification is significantly influenced by CVRFs, but differently in men and women.},
  author       = {Herbert, Annie and Cruickshank, John Kennedy and Laurent, St{\'e}phane and Boutouyrie, Pierre and The Reference Values for Arterial Measurements Collaboration, on behalf of and VERMEERSCH, SEBASTIAN and Rietzschel, Ernst and Van Bortel, Lucas and De Buyzere, Marc and Segers, Patrick and Gillebert, Thierry},
  issn         = {0195-668X},
  journal      = {EUROPEAN HEART JOURNAL},
  language     = {eng},
  number       = {44},
  pages        = {3122--3133},
  title        = {Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehu293},
  volume       = {35},
  year         = {2014},
}

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