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document
Monitoring of the central pulse pressure is useful for detecting cardiac overload during antiadrenergic treatment : the Japan Morning Surge 1 study . OBJECTIVE Lowering of the central pulse pressure ( PP ) has been shown to contribute to an improvement of the cardiac damage beyond that of lowering the brachial PP . We assessed the hypothesis that the change in the central PP is more useful than that in the brachial PP in the assessment of the change in cardiac load . METHODS We studied 434 treated hypertensive patients whose home systolic blood pressure was 135 mmHg or higher . They were followed for 6 months after allocation to either a control group or an added treatment group ( doxazosin 1-4 mg and atenolol when needed ) . We measured the brachial and central ( carotid ) blood pressure simultaneously using a validated device , and the B-type natriuretic peptide at baseline and at the sixth month of treatment . RESULTS In the added treatment group , the brachial systolic blood pressure was successfully reduced , but the central PP increased significantly , whereas the other blood pressure parameters did not change from the baseline . In the added treatment group , the change in the B-type natriuretic peptide was significantly correlated with the change in the brachial PP ( r = 0.18 ) , central systolic blood pressure ( r = 0.18 ) , central PP ( r = 0.26 ) , and PP amplification ( r = -0.22 ) even after adjusting for the confounding factors . The correlation with the central PP was stronger than with the brachial PP ( P = 0.018 ) or central systolic blood pressure ( P = 0.002 ) , and these relationships were essentially the same even after adjustment for the use of atenolol or the change in heart rate . CONCLUSION This study showed that the central PP measurement may be more important to assess cardiac load than the brachial PP during antiadrenergic treatment .
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Intervention_Control
control group
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Intervention_Pharmacological
doxazosin 1-4 mg
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Intervention_Pharmacological
atenolol
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Intervention_Pharmacological
atenolol
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Intervention_Pharmacological
antiadrenergic treatment
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Outcome_Physical
central pulse pressure
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Outcome_Physical
central pulse pressure
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Outcome_Physical
brachial systolic blood pressure
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Outcome_Physical
central PP
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Outcome_Physical
brachial PP
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Outcome_Physical
central systolic blood pressure
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Outcome_Physical
central PP
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Outcome_Physical
PP amplification
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Outcome_Physical
brachial PP
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Outcome_Physical
central systolic blood pressure
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Outcome_Physical
central PP measurement
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Participant_Sample-size
434
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Participant_Condition
hypertensive patients
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Participant_Condition
systolic blood pressure was 135 mmHg or higher