Objectives: Central blood pressure (BP) can be used to define hypertension. A central BP approach may be more sensitive than a conventional brachial BP approach in detecting hypertension. We aimed to compare the two approaches in estimating the prevalence hypertension in a nationally representative population. Methods: A total of 2742 adults older than 19 years participated in the 2013-2016 National Nutrition and Health Survey in Taiwan. Central and brachial BP were simultaneously measured using a cuff-based stand-alone central BP monitor purporting to measure invasive central BP (Type II device). Central hypertension was defined by central systolic/diastolic BP >/= 130 or 90 mmHg or using anti-hypertensive medications, and brachial hypertension was defined by brachial systolic/diastolic BP >/=140 or 90 mmHg or using anti-hypertensive medications. Results: The World Health Organization-standardized and national weighted prevalence rates of central hypertension were 27.95% and 32.48%, respectively, and both were significantly higher than those of brachial hypertension (20.80% and 25.43%, both P<0.001). The national weighted prevalence rates of concordant central and brachial hypertension, concordant central and brachial non-hypertension, isolated central hypertension, and isolated brachial hypertension were 25.13%, 67.22%, 7.35%, and 0.30%, respectively. Most subjects with the isolated central hypertension (97%) were within the range of brachial prehypertension, but only 38.0% of subject with brachial prehypertension had central hypertension. Conclusion: Almost one-third of a nationally representative population had hypertension detected by a central BP approach. Hypertension detection using a conventional brachial BP approach may underestimate the prevalence of hypertension and result in a less effective hypertension control.
Date:
2018-03
Relation:
American Journal of Hypertension. 2018 Mar;31(3):346-354.
