Central and brachial pulse pressure predicts cardiovascular and renal events in treated hypertensive patients

Figures & data

Table 1. Patient backgrounds.

Variable	Average (Prevalence)	Min.	Max.
Age (y/o)	66 ± 11	35	93
Sex (male)	49%
Height (cm)	158 ± 9	125	190
Weight (kg)	61 ± 12	28	143
Diabetes	27%
Dyslipidemia	48%
History of MI	4%
History of stroke	6%
Serum creatinine (umol/L)	71.6 ± 26.5	27.4	263.4
Brachial SBP (mmHg)	138 ± 18	75	221
Brachial DBP (mmHg)	79 ± 13	36	138
cPP (mmHg)	50 ± 15	12	137
bPP (mmHg)	60 ± 14	17	143
Pulse rate (bpm)	69 ± 11	40	116
Numbers of antihypertensives	2.03 ± 1.07	1	6

Continuous data were expressed as mean ± standard deviation. MI: myocardial infarction; SBP: systolic blood pressure; DBP: diastolic blood pressure; cPP: central pulse pressure; bPP: brachial pulse pressure; bpm: beats per minute; Min: minimum value; Max; maximum value.

Figure 1. Kaplan–Meier analysis for cardiovascular events above and below the median of central pulse pressure (cPP, left panel) and brachial pulse pressure (bPP, right panel). Log-rank test demonstrated significant differences between the two groups.

Table 2. Summary of Cox regression for cardiovascular events.

	Univariate cox				Multivariate cox
Variables	HR	CI	Wald	Probability	HR	CI	Wald	Probability
Sex	2.31	1.36–3.93	9.58	0.002	3.77	1.74–8.18	11.3	0.001
Age	1.03	1.01–1.06	6.29	0.02	1.01	0.98–1.04	0.22	0.63
Height	1.00	0.98–1.03	0.07	0.80	0.96	0.93–0.99	4.21	0.04
Weight	1.01	0.99–1.03	0.50	0.48	1.01	0.98–1.04	0.24	0.62
DM	1.65	0.98–2.79	3.46	0.06	1.35	0.78–2.35	1.15	0.28
DL	1.37	0.84–2.25	1.55	0.21	1.18	0.71–1.96	0.39	0.53
History of M/S	5.70	3.30–9.81	39.2	0.001	4.37	2.47–7.72	25.8	0.001
Scr	1.35	0.73–2.50	0.92	0.34	0.78	0.33–1.80	0.36	0.55
cPP	1.02	1.01–1.04	6.30	0.01	1.02	1.00–1.03	3.99	0.04
bPP	1.02	1.00–1.03	5.22	0.02	0.99	0.95–1.04	0.09	0.77
PR	0.99	0.97–1.01	0.69	0.41	1.00	0.98–1.03	0.05	0.83
NAD	1.32	1.09–1.60	8.10	0.004	1.25	1.00–1.56	3.96	0.04

HR: hazard ratio; CI: confidential interval; DM: Diabetes mellitus; DL: dyslipidemia; M/S: myocardial infarction and/or stroke; Scr: serum creatinine; cPP: central pulse pressure; bPP: brachial pulse pressure; PR: pulse rate; NAD: number of antihypertensive drugs. Of note, bPP was cancelled out of significant independent variables for cardiovascular events, similarly to multivariate Cox regression with restricted independent variables (Supplemental Table 3).

Table 3. Summary of Cox regression for renal events.

	Univariate cox				Multivariate cox
Variables	HR	CI	Wald	Probability	HR	CI	Wald	Probability
Sex	1.86	0.93–3.71	3.06	0.08	0.67	0.19–2.38	0.39	0.53
Age	0.96	0.93–0.99	7.39	0.01	1.01	0.97–1.06	0.38	0.54
Height	1.00	0.98–1.03	0.41	0.84	0.96	0.89–1.04	1.03	0.31
Weight	1.01	0.98–1.04	0.38	0.54	1.00	0.96–1.05	0.01	0.92
DM	2.28	1.12–4.67	5.10	0.02	1.64	0.67–4.06	1.16	0.28
DL	0.65	0.32–1.34	1.36	0.24	1.39	0.58–4.06	0.53	0.47
History of M/S	1.99	0.59–6.66	1.24	0.27	2.28	0.60–8.62	1.45	0.23
Scr	13.07	8.38–20.4	128	0.001	21.0	10.8–40.9	80.2	0.001
cPP	0.99	0.96–1.01	0.81	0.34	0.95	0.88–1.02	1.13	0.28
bPP	1.04	1.00–1.08	4.59	0.03	1.07	1.01–1.13	4.10	0.04
PR	1.00	0.97–1.03	0.24	0.88	0.99	0.94–1.03	0.53	0.47
NAD	1.59	1.27–2.01	15.7	0.001	0.85	0.63–1.15	1.10	0.29

HR: hazard ratio; CI: confidential interval; DM: Diabetes mellitus; DL: dyslipidemia; M/S: myocardial infarction and/or stroke; Scr: serum creatinine; cPP: central pulse pressure; bPP: brachial pulse pressure; PR: pulse rate; NAD: number of antihypertensive drugs. Of note; cPP was excluded from significant independent variables for renal events, as with the multivariate Cox regression with restricted independent variables (Supplemental Table 3).