Central Blood Pressure Over 24 Hours (ABPM) and Left Ventricular Mass

Central Blood Pressure Over 24 Hours (ABPM) and Left Ventricular Mas

The investigators aim to investigate whether central systolic blood pressure, as measured during regular 24 hour ambulatory blood pressure monitoring (ABPM), is a better predictor of left ventricular mass than peripheral systolic blood pressure during ABPM.

Study Overview

• Status: Completed
• Conditions: Suspected Arterial Hypertension
• Intervention / Treatment: Other: no intervention performed

Detailed Description

It seems obvious that central blood pressures are pathophysiologically more relevant than peripheral blood pressures for the pathogenesis of cardiovascular disease: it is central systolic pressure (cSBP) against the heart ejects (afterload), and it is central pulse pressure (cPP) that distends the large elastic arteries. Indeed, cSBP and cPP have been associated more closely with left ventricular hypertrophy and carotid atherosclerosis as markers of hypertensive end-organ damage than brachial pressures in various populations. However, in these studies office blood pressure measurements have been used. As ABPM measurements per se show a closer association with hypertensive end-organ damage than office measurements, and as the investigators have recently developed and validated a novel algorithm (ARCSolver) to calculate central blood pressures from peripheral waveforms, the investigators speculate that cSBP measured during ABPM may be the best predictor of left ventricular mass.

• Study Type: Observational
• Enrollment (Actual): 350

Contacts and Locations

Study Locations

• Austria
  • Graz, Austria
    • Cardiology Department, University of Graz
  • Upper Austria
    • Wels, Upper Austria, Austria, 4600
      • Cardiology Department, Klinikum Wels-Grieskirchen
• Germany
  • Lübeck, Germany
    • Cardiology Department, University of Lübeck
• Greece
  • Athens, Greece
    • Sotiria Hospital 3rd Department of Internal Medicine
• Italy
  • Brescia, Italy
    • Department of Medical and Surgical Sciences, University of Brescia
  • Monza, Italy
    • Clinica Medica, Hospitalo San Gerardo
  • Perugia, Italy
    • Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia
• Spain
  • Puerto de Sagunto, Spain, E - 46520
    • Hospital de Sagunto
• Switzerland
  • Basel, Switzerland
    • University of Basel
• United Kingdom
  • Cambridge, United Kingdom
    • Clinical pharmacology unit, University of Cambridge

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

community sample

Description

Inclusion Criteria:

> 18 years of age,

• no intake of antihypertensive medications
• should have an indication for ABPM (suspected arterial hypertension)

Exclusion Criteria:

• no written informed consent
• left ventricular hypertrophy due to other reasons than hypertension (hypertrophic cardiomyopathy, infiltrative cardiomyopathy, valvular heart disease, congenital heart disease)
• inability to provide adequate echocardiographic readings
• segmental contraction abnormalities of the left ventricle
• contraindications for ABPM (lymphedema both arms)
• other rhythm than stable sinus rhythm
• unstable clinical condition, including recent severe infections

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
untreated persons with suspected hypertension	Other: no intervention performed; no intervention is performed

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Left ventricular mass (m-mode echocardiography)	measured within 4 weeks from ABPM

Secondary Outcome Measures

Outcome Measure	Time Frame
urine albumine / creatinine ratio	measured within 2 weeks from ABPM but before antihypertensive treatment is started

Collaborators and Investigators

• Sponsor: Klinikum Wels-Grieskirchen
• Collaborators: European Regional Development Fund; Austrian Society of Hypertension; I.E.M. (Stolberg, Germany)
• Investigators: Principal Investigator: Thomas Weber, MD, associate professor, Cardiology Department, Klinikum Wels-Grieskirchen, Austria

Publications and helpful links

General Publications

• Weber T, Wassertheurer S, Schmidt-Trucksass A, Rodilla E, Ablasser C, Jankowski P, Lorenza Muiesan M, Giannattasio C, Mang C, Wilkinson I, Kellermair J, Hametner B, Pascual JM, Zweiker R, Czarnecka D, Paini A, Salvetti M, Maloberti A, McEniery C. Relationship Between 24-Hour Ambulatory Central Systolic Blood Pressure and Left Ventricular Mass: A Prospective Multicenter Study. Hypertension. 2017 Dec;70(6):1157-1164. doi: 10.1161/HYPERTENSIONAHA.117.09917. Epub 2017 Oct 23.

Study record dates

Study Major Dates

• Study Start: January 1, 2011
• Primary Completion (Actual): March 1, 2015
• Study Completion (Actual): March 1, 2015

Study Registration Dates

• First Submitted: January 18, 2011
• First Submitted That Met QC Criteria: January 18, 2011
• First Posted (Estimate): January 19, 2011

Study Record Updates

• Last Update Posted (Estimate): April 3, 2015
• Last Update Submitted That Met QC Criteria: March 31, 2015
• Last Verified: March 1, 2015

More Information

Terms related to this study

• Keywords: arterial hypertension
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Hypertension
• Other Study ID Numbers: EK D-4-10