ECG Voltage in Relation to Peripheral and Central Ambulatory Blood Pressure

Wen-Yi Yang, Blerim Mujaj, Ljupcho Efremov, Zhen-Yu Zhang, Lutgarde Thijs, Fang-Fei Wei, Qi-Fang Huang, Aernout Luttun, Peter Verhamme, Tim S. Nawrot, Jose Boggia, Jan A. Staessen*

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    8 Citations (Web of Science)

    Abstract

    BACKGROUND The heart ejects in the central elastic arteries. No previous study in workers described the diurnal profile of central blood pressure (BP) or addressed the question whether electrocardiogram (ECG) indexes are more closely associated with central than peripheral BP. METHODS In 177 men (mean age, 29.1 years), we compared the associations of ECG indexes with brachial and central ambulatory BP, measured over 24 hours by the validated oscillometric Mobil-O-Graph 24h PWA monitor. RESULTS From wakefulness to sleep, as documented by diaries, systolic/diastolic BP decreased by 11.7/13.1 mm Hg peripherally and 9.3/13.6 mm Hg centrally, whereas central pulse pressure (PP) increased by 4.3 mm Hg (P < 0.0001). Over 24 hours and the awake and asleep periods, the peripheral-minus-central differences in systolic/diastolic BPs averaged 11.8/-1.6, 12.7/-1.8, and 10.3/-1.2 mm Hg, respectively (P < 0.0001). Cornell voltage and index averaged 1.18 mV and 114.8 mV.ms. Per 1-SD increment in systolic/diastolic BP, the Cornell voltages were 0.104/0.086 mV and 0.082/0.105 mV higher in relation to brachial 24-hour and asleep BP and 0.088/0.90 mV and 0.087/0.107 mV higher in relation to central BP. The corresponding estimates for the Cornell indexes were 9.6/8.6 and 8.2/10.5 mV.ms peripherally and 8.6/8.9 and 8.8/10.7 mV.ms centrally. The regression slopes (P = 0.067) and correlation coefficients (P = 0.088) were similar for brachial and central BP. Associations of ECG measurements with awake BP and PP were not significant. CONCLUSIONS Peripheral and central BPs run in parallel throughout the day and are similarly associated with the Cornell voltage and index.
    Original languageEnglish
    Pages (from-to)178-187
    Number of pages10
    JournalAmerican Journal of Hypertension
    Volume31
    Issue number2
    DOIs
    Publication statusPublished - 12 Jan 2018

    Keywords

    • ambulatory blood pressure
    • blood pressure
    • blood pressure monitoring
    • central blood pressure
    • clinical science
    • ECG voltage
    • hypertension
    • LEFT-VENTRICULAR HYPERTROPHY
    • SOCIETY-OF-HYPERTENSION
    • CENTRAL AORTIC PRESSURE
    • EUROPEAN-SOCIETY
    • CARDIOVASCULAR EVENTS
    • BRACHIAL PRESSURE
    • VALIDATION
    • WAVE
    • RECOMMENDATIONS
    • POPULATION

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