TY - JOUR
T1 - Central Systolic Blood Pressure and Left Ventricular Mass
T2 - Findings From the International 24-Hour Aortic Blood Pressure Consortium
AU - Danninger, Kathrin
AU - Athanasopoulou, Elpida
AU - Agharazii, Mohsen
AU - Argyris, Antonios A.
AU - Bahous, Sola Aoun
AU - Banegas, Jose R.
AU - Binder, Ronald K.
AU - Blacher, Jacques
AU - Brandao, Andrea A.
AU - Brandt, Matthias C.
AU - de la Sierra, Alejandro
AU - Gkaliagkousi, Eugenia
AU - Giannattasio, Cristina
AU - Hametner, Bernhard
AU - Jankowski, Piotr
AU - Kollias, Anastasios
AU - Li, Yan
AU - Maloberti, Alessandro
AU - Mayer, Christopher C.
AU - McDonnell, Barry J.
AU - McEniery, Carmel M.
AU - Karachalias, Fotis
AU - Gomes, Antonio Mota
AU - Muiesan, Maria L.
AU - Nemcsik, Janos
AU - Paiva, Annelise M.G.
AU - Piskorz, Daniel
AU - Pucci, Giacomo
AU - Rodilla, Enrique
AU - Sfikakis, Petros P.
AU - Stergiou, George S.
AU - Terentes-Printzios, Dimitrios
AU - Vlachopoulos, Charalambos
AU - Wilkinson, Ian
AU - Protogerou, Athanase D.
AU - Sharman, James E.
AU - Wassertheurer, Siegfried
AU - Weber, Thomas
N1 - Publisher Copyright:
© 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
PY - 2026/7/3
Y1 - 2026/7/3
N2 - BACKGROUND: Central systolic blood pressure (cSBP) reflects the pressure experienced by vital organs and may be more closely related to hypertensive cardiac damage than brachial SBP. Twenty-four–hour ambulatory blood pressure monitoring provides additional insight into cardiovascular load beyond office readings. This study investigated the association of 24-hour cSBP, measured noninvasively with a validated device, with left ventricular mass index (LVMi) and LV hypertrophy. METHODS: We analyzed data from 21 centers worldwide (n=2367; 45.5% women; mean age 49.5years) participating in the International 24-Hour Aortic Blood Pressure Consortium. Brachial and central 24-hour SBPs were recorded using the Mobil-O-Graph device, calibrated by either systolic/diastolic (cSBP C1) or mean/diastolic (cSBP C2) pressure; LVMi was derived echocardiographically. BP phenotypes (normotension, isolated diastolic and systolic hypertension, and systolic-diastolic hypertension) were based on 24-hour brachial BPs, subdivided by cSBP. RESULTS: LVMi correlated most strongly with 24-hour cSBP C2 (P<0.001) consistently, across sex, body mass index (BMI), age, and treatment strata. Receiver operating characteristic analysis showed superior prediction of LV hypertrophy for 24-hour cSBP C2 (area under the curve=0.68). Both brachial BP phenotype and central SBP status were independently associated with LVMi (P=0.0045 and <0.001, respectively), without interaction. Discordant classification occurred in 14.4% of participants and was linked to higher LVMi in normotension and lower LVMi in systolic-diastolic hypertension. CONCLUSIONS: Twenty-four–hour central SBP calibrated with oscillometric mean/diastolic pressure (cSBP C2), is more closely associated with LVMi and LV hypertrophy than brachial SBP. These findings highlight the potential clinical value of incorporating central pressure monitoring into risk assessment and hypertension management.
AB - BACKGROUND: Central systolic blood pressure (cSBP) reflects the pressure experienced by vital organs and may be more closely related to hypertensive cardiac damage than brachial SBP. Twenty-four–hour ambulatory blood pressure monitoring provides additional insight into cardiovascular load beyond office readings. This study investigated the association of 24-hour cSBP, measured noninvasively with a validated device, with left ventricular mass index (LVMi) and LV hypertrophy. METHODS: We analyzed data from 21 centers worldwide (n=2367; 45.5% women; mean age 49.5years) participating in the International 24-Hour Aortic Blood Pressure Consortium. Brachial and central 24-hour SBPs were recorded using the Mobil-O-Graph device, calibrated by either systolic/diastolic (cSBP C1) or mean/diastolic (cSBP C2) pressure; LVMi was derived echocardiographically. BP phenotypes (normotension, isolated diastolic and systolic hypertension, and systolic-diastolic hypertension) were based on 24-hour brachial BPs, subdivided by cSBP. RESULTS: LVMi correlated most strongly with 24-hour cSBP C2 (P<0.001) consistently, across sex, body mass index (BMI), age, and treatment strata. Receiver operating characteristic analysis showed superior prediction of LV hypertrophy for 24-hour cSBP C2 (area under the curve=0.68). Both brachial BP phenotype and central SBP status were independently associated with LVMi (P=0.0045 and <0.001, respectively), without interaction. Discordant classification occurred in 14.4% of participants and was linked to higher LVMi in normotension and lower LVMi in systolic-diastolic hypertension. CONCLUSIONS: Twenty-four–hour central SBP calibrated with oscillometric mean/diastolic pressure (cSBP C2), is more closely associated with LVMi and LV hypertrophy than brachial SBP. These findings highlight the potential clinical value of incorporating central pressure monitoring into risk assessment and hypertension management.
KW - 24-hour blood pressure monitoring
KW - central systolic blood pressure
KW - echocardiography
KW - hypertrophy
KW - left ventricular
KW - left ventricular mass
KW - multicenter study
UR - https://www.scopus.com/pages/publications/105050211901
U2 - 10.1161/JAHA.125.048665
DO - 10.1161/JAHA.125.048665
M3 - Article
C2 - 42396797
AN - SCOPUS:105050211901
SN - 2047-9980
VL - 15
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 16
M1 - e048665
ER -