Association of central arterial blood pressure and left ventricular hypertrophy in patients with chronic kidney disease

Abstract

\n Aims: In the general population, central arterial blood pressure has proved to be more closely related to left ventricular hypertrophy than brachial arterial blood pressure. We aimed to investigate whether this relationship was true in patients with chronic kidney disease. Methods: In this retrospective study, we reviewed the medical records of 289 adult patients with chronic kidney disease from the Zhejiang Provincial People’s Hospital in Zhejiang, China. Demographic, echocardiographic, and brachial and central blood pressure parameters were retrieved from medical records. Central blood pressure was measured using the SphygmoCor® CvMS (AtCor, Australia) device and its corresponding software. Multivariate logistic regression analyses were performed to identify independent predictors of left ventricular hypertrophy. Receiver operating characteristic curves were used to determine the ability of central and brachial blood pressure to predict left ventricular hypertrophy.Results: The left ventricular mass index was positively associated with both central and brachial blood pressures. However, multiple logistic regression analysis demonstrated that a central pulse pressure ≥ 58 mm Hg was an independent risk factor for left ventricular hypertrophy (OR=5.597, 95%CI 2.363-13.259, P <0.001). Brachial pulse pressure is not superior to central pulse pressure in predicting left ventricular hypertrophy (AUC = 0.695, 95%CI 0.634-0.756, P < 0.001 vs. AUC = 0.687, 95%CI: 0.626 to 0.748, P < 0.001, respectively; P = 0.4824).Conclusions: Our results suggested that, similarly to the general population, central pulse pressure is a better parameter for predicting the occurrence of left ventricular hypertrophy in patients with chronic kidney disease.