Spurious systolic hypertension in youth: what does it really mean in clinical practice?

In clinical practice, brachial blood pressure measurement remains the classical reference for identifying hypertension, but this has been challenged recently. Indeed, estimation of central aortic pressure has been shown to be a stronger predictor of coronary artery disease [1,2] and even brings new insights regarding the effect of different antihypertensive drugs, as documented in the Conduit Artery Function Evaluation (CAFE) study. CAFE is a sub-study of the large Anglo-Scandinavian Cardiac Outcomes trial (ASCOT) in which, despite the similar control of brachial blood pressure, aortic blood pressure was significantly lower in the amlodipine-perindopril arm compared to the betablocker-diuretic arm [3,4].