Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Commentary
  • Published:

Sense and sensibility

Journal of Human Hypertension volume 26, pages 1–2 (2012)Cite this article

Sphygmomanometry and electrocardiography (ECG) are fundamental tools in cardiovascular medicine since more than 100 years. They are manifested by their specious simplicity and their proven value in large scale epidemiological observations for numerous indications e.g. left ventricular hypertrophy (LVH). Based thereupon new sensors and concepts like echocardiography (ECHO) or central blood pressure (CBP), designed to increase sensitivity and/or specificity, evolved. In the last 10 years, the superiority of central over peripheral arterial hemodynamics has been repeatedly documented and recently summarized.1 Additionally the role of left ventricular hypertrophy as a measure of hypertensive end-organ damage and as independent predictor of outcome has been emphasized in major guidelines.2 The relationship between CBP and LVH has also been well described,3 again with central pressures being closer associated with left ventricular wall thickness and mass than peripheral pressures.

Typically in studies of this kind, echocardiography was used for assessment of left ventricular mass. In clinical routine, electrocardiography often is the first method to diagnose LVH, and major outcome trials have included patients with LVH on the basis of ECG-criteria rather than echocardiograms.4 In general ECG is less sensitive compared to ECHO, but highly specific in diagnosing LVH. Surprisingly the relationship between CBP and LVH characterized by ECG has not been investigated so far. Wohlfahrt and colleagues have started to fill this gap. In their actual study5 on the relation of CBP and ECG-LVH, they showed that non invasively determined CBP in subjects over 45 years is stronger related to ECG-LVH than brachial blood pressure, further supporting the concept of the superiority of central pressures.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Vlachopoulos C, Aznaouridis K, O’Rourke MF, Safar ME, Baou K, Stefanadis C . Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J 2010; 31: 1865–1871.

    Article  Google Scholar 

  2. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G et al. 2007 Guidelines for the management of arterial hypertension. Eur Heart J 2007; 28: 1462–1536.

    Google Scholar 

  3. Roman MJ, Okin PM, Kizer JR, Lee ET, Howard BV, Devereux RB . Relations of central and brachial blood pressure to left ventricular hypertrophy and geometry: the Strong Heart Study. J Hypertens 2010; 28: 384–388.

    Article  CAS  Google Scholar 

  4. Dahlöf B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. The Lancet 2002; 359: 995–1003.

    Article  Google Scholar 

  5. Wohlfahrt P, Wichterle D, Seidlerová J, Filipovský J, Bruthans J, Adámková V et al. Relation of central and brachial blood pressure to left ventricular hypertrophy: The Czech Post-MONICA study. J Hum Hypertens 2012 26:14–19

    Article  CAS  Google Scholar 

  6. Weber T, Wassertheurer S, Rammer M, Maurer E, Hametner B, Mayer CC et al. Validation of a brachial cuff-based method for estimating central systolic blood pressure. Hypertension 2011 (e-pub ahead of print 12 September 2011; doi:10.1161/hypertensionaha.111.176313).

  7. Wassertheurer S, Kropf J, Weber T, van der Giet M, Baulmann J, Ammer M et al. A new oscillometric method for pulse wave analysis: comparison with a common tonometric method. J Hum Hypertens 2010; 24: 498–504.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health & Environment Department, AIT Austrian Institute of Technology, Vienna, Austria

    S Wassertheurer

  2. Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria

    T Weber

Authors
  1. S Wassertheurer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Wassertheurer.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wassertheurer, S., Weber, T. Sense and sensibility. J Hum Hypertens 26, 1–2 (2012). https://doi.org/10.1038/jhh.2011.92

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2011.92

This article is cited by

Search

Advanced search

Quick links