Use a central systolic blood pressure threshold of 135 mmHg to define central hypertension.
Assess both brachial and central blood pressure to classify patients into normotension, isolated brachial hypertension, isolated central hypertension, or concordant hypertension.
Management
Recognize individuals with isolated central hypertension as at elevated cardiovascular risk regardless of brachial blood pressure status.
Monitoring & Follow-up
Implement cuff-based central blood pressure measurement devices for simultaneous brachial and central BP assessment in routine clinical practice.
Risks
Isolated central hypertension carries a higher cardiovascular risk than isolated brachial hypertension.
Ignoring central blood pressure may underestimate cardiovascular risk.
Patient & Prescribing Data
Adults without prior cardiovascular disease undergoing blood pressure assessment
Patients with central systolic BP ≥135 mmHg should be considered at increased cardiovascular risk even if brachial BP is normal, warranting closer monitoring and potential intervention.
Clinical Best Practices
Measure central blood pressure using validated cuff-based devices alongside brachial blood pressure.
Use the 135 mmHg central systolic BP threshold to identify central hypertension.
Classify patients by combined brachial and central BP phenotypes to better stratify cardiovascular risk.
Incorporate central BP measurements into cardiovascular risk models to improve prediction accuracy.
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