  Author information
1Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W., R.K.B., K.D.).
2Cardiovascular Prevention and Research Unit, Clinic-Laboratory of Pathophysiology and First Department of Propeadeutic Internal Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Greece (A.D.P., A.A., P.P.S.).
3Centre de Recherche Du CHU de Québec, Université Laval, Canada (M.A.).
4Cardiovascular Prevention and Research Unit, Clinic-Laboratory of Pathophysiology and First Department of Propeadeutic Internal Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Greece (A.D.P., A.A., P.P.S.).
5Lebanese American University School of Medicine, Byblos, Lebanon (S.A.B.).
6Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health, Spain (J.R.B., J.J.C., A.G.).
7Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W., R.K.B., K.D.).
8AP-HP Centre-Université de Paris, Hôpital Hôtel-Dieu, Centre de diagnostic et de thérapeutique, France (J.B., A.V.).
9State University of Rio de Janeiro, Brazil (A.A.B.).
10Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health, Spain (J.R.B., J.J.C., A.G.).
11Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W., R.K.B., K.D.).
12School of Medicine and Surgery, Milano-Bicocca University and Cardiology 4, ASST GOM Niguarda, Milan, Italy (C.G., A.M.).
13Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health, Spain (J.R.B., J.J.C., A.G.).
14Austrian Institute of Technology, Vienna, Austria (B.H., C.C.M., S.W.).
15Institute of Cardiology, Jagellonian University, Krakow, Poland (P.J.).
16Centre for Vascular Evaluations, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L.).
17School of Medicine and Surgery, Milano-Bicocca University and Cardiology 4, ASST GOM Niguarda, Milan, Italy (C.G., A.M.).
18Experimental Medicine and Immunotherapeutics, Addenbrooke's Hospital, University of Cambridge, United Kingdom (C.M.M., I.W.).
19Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom (B.J.M.).
20Austrian Institute of Technology, Vienna, Austria (B.H., C.C.M., S.W.).
21Centro Universitario CESMAC, Alagoas, Brazil (M.A.M.G., A.M.G.).
22Centro Universitario CESMAC, Alagoas, Brazil (M.A.M.G., A.M.G.).
23Department of Clinical and Experimental Sciences, Centro per la Prevenzione e Cura dell'ipertensione Arteriosa, University of Brescia and ASST Spedali Civili, Italy (M.L.M., A.P.).
24Department of Family Medicine, Semmelweis University, Budapest, Hungary (J.N.).
25Department of Clinical and Experimental Sciences, Centro per la Prevenzione e Cura dell'ipertensione Arteriosa, University of Brescia and ASST Spedali Civili, Italy (M.L.M., A.P.).
26Universidad Cardenal Herrera-CEU, CEU Universities, Hospital de Sagunto, Valencia, Spain (E.R.).
27School of Population Health, University of New South Wales, Sydney, Australia (A.E.S.).
28Cardiovascular Prevention and Research Unit, Clinic-Laboratory of Pathophysiology and First Department of Propeadeutic Internal Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Greece (A.D.P., A.A., P.P.S.).
29First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.).
30AP-HP Centre-Université de Paris, Hôpital Hôtel-Dieu, Centre de diagnostic et de thérapeutique, France (J.B., A.V.).
31First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.).
32SAMRC/Wits Developmental Pathways for Health Research Unit, South Africa (L.W.).
33Experimental Medicine and Immunotherapeutics, Addenbrooke's Hospital, University of Cambridge, United Kingdom (C.M.M., I.W.).
34Department of Cardiology, Medical University Graz, Austria (R.Z.).
35Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (J.E.S.).
36Austrian Institute of Technology, Vienna, Austria (B.H., C.C.M., S.W.).
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Abstract
Central (aortic) systolic blood pressure (cSBP) is the pressure seen by the heart, the brain, and the kidneys. If properly measured, cSBP is closer associated with hypertension-mediated organ damage and prognosis, as compared with brachial SBP (bSBP). We investigated 24-hour profiles of bSBP and cSBP, measured simultaneously using Mobilograph devices, in 2423 untreated adults (1275 women; age, 18-94 years), free from overt cardiovascular disease, aiming to develop reference values and to analyze daytime-nighttime variability. Central SBP was assessed, using brachial waveforms, calibrated with mean arterial pressure (MAP)/diastolic BP (cSBP), or bSBP/diastolic blood pressure (cSBP), and a validated transfer function, resulting in 144 509 valid brachial and 130 804 valid central measurements. Averaged 24-hour, daytime, and nighttime brachial BP across all individuals was 124/79, 126/81, and 116/72 mm Hg, respectively. Averaged 24-hour, daytime, and nighttime values for cSBP were 128, 128, and 125 mm Hg and 115, 117, and 107 mm Hg for cSBP, respectively. We pragmatically propose as upper normal limit for 24-hour cSBP 135 mm Hg and for 24-hour cSBP 120 mm Hg. bSBP dipping (nighttime-daytime/daytime SBP) was -10.6 % in young participants and decreased with increasing age. Central SBP dipping was less pronounced (-8.7% in young participants). In contrast, cSBP dipping was completely absent in the youngest age group and less pronounced in all other participants. These data may serve for comparison in various diseases and have potential implications for refining hypertension diagnosis and management. The different dipping behavior of bSBP versus cSBP requires further investigation.
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