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Two Major Outcome Studies Demonstrate The
Clinical Significance of Central Blood Pressures
Two major cardiovascular outcomes trials presented at American Heart Association Scientific Sessions 2005 – the Conduit Artery Functional Endpoint (CAFE)1study and a NIH-sponsored Strong Heart sub-study2 – establish the importance of central blood pressures in assessing cardiovascular risk and the ef ects ofpharmacologic therapy on clinical outcomes. These studies both showed central pressure to be superior to brachial cuf pressure.
The CAFE sub-study of the ASCOT Trial included 2,199 hypertensive patients. The CAFE study used SphygmoCor® to investigate whether the two drugtreatment regimens – amlodipine/perindopril and atenolol/thiazidem, which showed no dif erence in brachial pressure reduction – had dif erential ef ectson central blood pressure, and whether such dif erential ef ects might explain the dif erences in cardiovascular outcomes observed in the primary ASCOTtrial. CAFE found that central aortic systolic blood pressure was 4.3 mm Hg lower in the amlodipine/perindopril group, and that this group also had a3.0 mm Hg lower central pulse pressure. Superior outcomes in CAFE (and ASCOT) are attributable to greater reduction in aortic systolic pressure.
Lead investigator, Dr Bryan Wil iams (University of Leicester, UK) said, “CAFE demonstrates…that blood pressure lowering drugs have significantlydifferent effects on central arterial blood pressure, despite having a similar impact on peripheral blood pressure. The results of this study are clear-cut,dramatic and potential y very important.” The SphygmoCor System is easily incorporated into clinical practice, with Dr Wil iams commenting, “cliniciansinterested in central pulse pressures, especial y in their high-risk or older patients with stiffer arteries, should be able to use the system ef ectively5.”
The Strong Heart sub-study used SphygmoCor® to investigate central as wel as brachial blood pressure, and fol owed 2,409 subjects for amean of 4.0 years. The study concluded that non-invasively determined central aortic systolic pressure was an independent predictor of incidentcardiovascular disease, while these events were not related to brachial systolic pressure. Central aortic pressure, therefore better predicts incidentcardiovascular disease, likely due to a more accurate representation of the vascular load on the left ventricle.
Only SphygmoCor®can provide central blood pressure and
key indices of cardiovascular risk…non-invasively.
SphygmoCor® is only available from AtCor Medical.
1 Central Blood Pressure Better Predicts Cardiovascular Events Than Does Peripheral Blood Pressure – The Strong Heart Study (Mary Roman, Cornell Univ, et al); Epidemiology: Traditional CVD Risk Factors, 4:00 pm, Sunday November 13.
2 Differential Impact of Blood Pressure-Lowering Drugs on Central Arterial Pressure Influences Clinical Outcomes – Principal Results of the Conduit Artery Functional Evaluation (CAFE) Study in ASCOT (Bryan Williams, Univ Liecester);
Late Breaking Clinical Trials 1, 3:45 pm Sunday November 13.
3 New Data Show Hypertensive Patients Taking Norvasc-Based Regimen Achieved Better Central Blood Pressure Control. Yahoo Financial New, Sunday 13th November, 2005.
4 Norvasc better for lowering aortic blood pressure. Reuters, Sunday 13th November, 2005.
5 CAFE: Lower central aortic blood pressures with amlodipine and perindopril. www.thekidney.org, Sunday 13th November, 2005.
Meeting minutes from May approved. Dates for agency run reviews need to be finalized. Tish will send out the schedule that was previously created with the month each agency requested. Each agency needs to give a couple possible dates to schedule so a date can be confirmed with Dr Burns schedule. Patch format: 1 set of vitals for a BLS refusal is acceptable. 2 sets of vitals are required
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