To calculate robust quantitative estimates on the predictive value of
central pressures and derived central haemodynamic indices for
cardiovascular (CV) outcomes and all-cause mortality by meta-analysis of
longitudinal studies.
We meta-analysed 11 longitudinal studies that had employed measures of
central haemodynamics and had followed 5648 subjects for a mean
follow-up of 45 months. The age- and risk-factor-adjusted pooled
relative risk (RR) of total CV events was 1.088 (95% CI 1.040-1.139)
for a 10 mmHg increase of central systolic pressure, 1.137 (95% CI
1.063-1.215) for a 10 mmHg increase of central pulse pressure (PP), and
1.318 (95% CI 1.093-1.588) for a 10% absolute increase of central
augmentation index (AIx). Furthermore, we found that a 10% increase of
central AIx was associated with a RR of 1.384 (95% CI 1.192-1.606) for
all-cause mortality. When compared with brachial PP, central PP was
associated with marginally but not significantly higher RR of clinical
events (P = 0.057).
Central haemodynamic indexes are independent predictors of future CV
events and all-cause mortality. Augmentation index predicts clinical
events independently of peripheral pressures, while central PP has a
marginally but not significantly (P = 0.057) better predictive ability
when compared with peripheral PP