1.6: Peripheral and Central Ambulatory Blood Pressure in Relation to ECG Voltage
Background The heart ejects in the central elastic arteries. No previous study addressed the question whether ECG voltages are more closely associated with central than with peripheral blood pressure (BP). Methods Using the oscillometric Mobil-O-Graph 24 h PWA monitor, we measured brachial, central...
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| Veröffentlicht in: | Artery research Jg. 20; H. 1; S. 48 - 49 |
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| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Dordrecht
Springer Netherlands
01.12.2017
Springer Nature B.V BMC |
| Schlagworte: | |
| ISSN: | 1872-9312, 1876-4401, 1876-4401 |
| Online-Zugang: | Volltext |
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| Zusammenfassung: | Background
The heart ejects in the central elastic arteries. No previous study addressed the question whether ECG voltages are more closely associated with central than with peripheral blood pressure (BP).
Methods
Using the oscillometric Mobil-O-Graph 24 h PWA monitor, we measured brachial, central BP and central hemodynamics over 24 hours in 177 men (mean age, 29.1 years), and linked to ECG voltages.
Results
From wakefulness to sleep, as documented by diaries, systolic/diastolic BP decreased by 11.7/13.1 mmHg peripherally and by 9.3/13.6 mmHg centrally, whereas pulse pressure (PP) increased by 4.3 mmHg. Over 24 hours and the awake and asleep periods, the peripheral-minus-central differences in systolic/diastolic BPs and pulse pressure averaged 11.8/−1.6, 12.7/−1.8 and 10.3/−1.2 mmHg and 13.4, 14.4 and 11.5 mmHg, respectively (P < 0.0001). Cornel voltage and index averaged 1.18 mV and 114.8 mV × ms. The Cornell voltages were 0.104/0.086 and 0.082/0.105 mV higher in relation to brachial 24-h and asleep systolic/diastolic BP (per 1-SD), respectively, and 0.088/0.90 mV and 0.087/0.107 mV higher in relation to central BP. The corresponding estimates for the Cornel indexes were 9.6/8.6 and 8.2/105 mV × ms peripherally and 8.6/8.9 and 8.8/10.7 mV × ms centrally. The regression slopes were similar for brachial and central BP (P ≥ 0.054). Associations of the ECG measurements with awake BP, PP, the augmentation ratio and pressure amplification did not reach significance.
Results
NIAGEN® safely and effectively raised circulating levels of NAD
+
and related metabolites. Although no effect was observed on endothelial function, NIAGEN® significantly lowered PWV as well as systolic (SBP) and diastolic blood pressure (DBP) in all subjects (P < 0.05). When separated by baseline BP status, the BP-lowering effect of NIAGEN® was observed in pre-hypertensive (pHTN, n = 13) but not normotensive (N = 11) individuals (P < 0.01). Interestingly, NIAGEN® was lowered in all subjects regardless of baseline BP status.
Conclusion
Chronic NIAGEN® supplementation lowers SBP in pHTN older adults and reduces aortic stiffness, independent of baseline blood pressure status.
Table
Association of ECG Cornell voltage and indexes with peripheral and central BP.
Cornell voltage (
S
V3
+ R
aVL
, mV)
Cornell index (Cornell voltage × QRS duration, mV · ms)
Peripheral BP
Central BP
Peripheral BP
Central BP
Estimate (95% CI)
P
Estimate (95% CI)
P
Estimate (95% CI)
P
Estimate (95% CI)
P
Systolic BP
24-h
0.104 (0.016 to 0.191)
0.021
0.088 (0.0003 to 0.177)
0.049
9.61 (0.65 to 18.57)
0.036
8.58 (−0.40 to 17.56)
0.061
Awake
0.086 (−0.001 to 0.175)
0.054
0.062 (−0.026 to 0.151)
0.17
7.69 (−1.30 to 16.69)
0.093
5.80 (−3.23 to 14.82)
0.21
Asleep
0.082 (−0.006 to 0.170)
0.068
0.087 (−0.001 to 0.175)
0.053
8.17 (−0.82 to 17.16)
0.075
8.76 (−0.217 to 17.74)
0.056
Diastolic BP
24-h
0.086 (−0.002 to 0.174)
0.056
0.090 (0.002 to 0.178)
0.045
8.57 (−0.41 to 17.55)
0.061
8.93 (−0.04 to 17.90)
0.051
Awake
0.056 (−0.032 to 0.145)
0.21
0.060 (−0.029 to 0.149)
0.18
5.62 (−3.42 to 14.65)
0.22
5.97 (−3.06 to 15.00)
0.19
Asleep BP
0.105 (0.017 to 0.192)
0.020
0.107 (0.019 to 0.194)
0.017
10.53 (1.60 to 19.47)
0.021
10.71 (1.78 to 19.64)
0.019
Pulse pressure
24-h
0.040 (−0.049 to 0.129)
0.38
0.016 (−0.073 to 0.105)
0.72
3.07 (−5.99 to 12.13)
0.50
1.31 (−7.76 to 10.38)
0.77
Awake
0.048 (−0.041 to 0.137)
0.29
0.012 (−0.077 to 0.101)
0.78
3.63 (−5.43 to 12.68)
0.43
0.68 (−8.40 to 9.74)
0.88
Asleep
0.001 (−0.091 to 0.088)
0.98
0.001 (−0.087 to 0.090)
0.98
−0.29 (−9.37 to 8.78)
0.95
0.21 (−8.86 to 9.28)
0.96
ECG refers to electrocardiography. BP stands for blood pressure. Cornell voltage is the voltage sum of S wave in precordial V3 lead (S
V3
) and R wave in limb aVL lead (
R
e
VL
), while Cornell index is the product of QRS duration multiplied by the Cornell voltage. The estimate (95% Confidence Interval, CI) of the association was unadjusted and expressed as 1-SD increase of BP.
P
value is for significance of the estimate. The association estimates of Cornell voltage (P ≥ 0.054) and index (P ≥ 0.079) with central BP were not significantly different from those estimates with peripheral measurements.
Conclusions
The diurnal rhythm of peripheral and central BP run in parallel. Central BP does not improve the association of Cornell voltage or index with peripheral BP. |
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| Bibliographie: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 |
| ISSN: | 1872-9312 1876-4401 1876-4401 |
| DOI: | 10.1016/j.artres.2017.10.020 |