Clinical and Cardiometabolic Characteristics Associated with Elevated Office Central Systolic Blood Pressure in Individuals with Normal Brachial Systolic Blood Pressure
Year: 2026
Type: article
Abstract: Background Residual cardiovascular risk may persist despite normal or controlled office brachial systolic blood pressure (b-SBP). Central systolic blood pressure (c-SBP) may provide complementary information on haemodynamic load not fully captured by b-SBP. We investigated whether elevated office c-SBP despite normal b-SBP identifies individuals with a less favorable cardiometabolic and vascular profile. Methods We performed a cross-sectional analysis of 3,395 adults with office b-SBP < 140. Elevated c-SBP was defined ≥ 130 mmHg.Clinical characteristics, cardiovascular risk factors, Mobil-O-Graph-derived estimated pulse wave velocity (ePWV), carotid plaque prevalence and total carotid plaque area (TCPA) were compared. Results Elevated office central SBP was present in 271 participants (8.0%). Compared with participants with central SBP < 130 mmHg, those with elevated central SBP were older, had higher body mass index, and more frequently had diagnosis of hypertension and diabetes. They also had higher e-cfPWV (8.20 ± 1.40 vs. 7.40 ± 1.43 m/s; p < 0.001), a modestly higher prevalence of carotid plaque (68.3% vs. 62.1%; p = 0.050), and larger median TCPA (21.1 vs. 14.0 mm²; p = 0.014). Elevated office c-SBP despite normal b-SBP was associated with carotid plaque in the unadjusted model (OR 1.31, 95% CI 1.01–1.72; p = 0.044), but not after adjustment for conventional cardiovascular risk factors (OR 1.13, 95% CI 0.82–1.56; p = 0.462) or after further adjustment for brachial SBP (OR 0.86, 95% CI 0.61–1.22; p = 0.403). Conclusion Elevated office c-SBP despite normal b-SBP identifies individuals with a less favorable cardiometabolic and haemodynamic profile. Although its association with carotid atherosclerosis was not independent of conventional cardiovascular risk factors and b-SBP, these findings, together with previous longitudinal evidence, raise the possibility that c-SBP may provide clinically relevant information not fully captured by office b-SBP alone. Prospective studies are warranted to determine its incremental prognostic value for cardiovascular and cerebrovascular outcomes.
Source: Artery Research
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,790
OpenAlex ID: W7225643508