Ji-Guang WANG, MD, PhD, FAHA, FESC
Professor of Cardiovascular Medicine
Shanghai Jiaotong University School of Medicine
Ji-Guang Wang is director of the Shanghai Institute of Hypertension, and director of the Department of Hypertension, Ruijin Hospital.
At present, he is coordinating several multicentre randomized clinical trials and population- and patient-cohort studies in China. He has published 526 full-length articles on hypertension in the international literature and 180 articles in the Chinese literature, and has lectured extensively in international and China national conferences.
He is a former Executive Council Member of the International Society of Hypertension, past president of the Asian-Pacific Society of Hypertension, past president of the Pulse of Asia Society, current deputy president of the HOPE Asia Network, and current president of the Chinese Hypertension League.
He serves on the editorial board of several international and China national journals in the field of hypertension and cardiovascular medicine as Editor-in-Chief, Associate Editor, Section Editor or a Member.
Keywords: hypertension, blood pressure, epidemiology, clinical trial
Central hypertension and central uncontrolled hypertension
Ji-Guang Wang, Yi-Bang Cheng, Yan Li
The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
With the cross-classification of central and brachial systolic blood pressure, it is possible to define central hypertension in untreated individuals and central uncontrolled hypertension in treated hypertensive patients. We recently found that individuals with a normal brachial systolic blood pressure (<130 mmHg) but an elevated central systolic blood pressure (≥120 mmHg) had a population prevalence of 3.7% and a higher risk of fatal and nonfatal cardiovascular events (hazard ratio 2.28, 95% confidence interval 1.21-4.30) and cerebrovascular events (hazard ratio 3.71, 95% confidence interval 1.37-10.06) than those with concordant normotension in both central and brachial systolic blood pressure (<120/<130 mmHg). In a systematic review and meta-analysis, we found that antihypertensive drugs behaved differently in reducing central systolic blood pressure with a greater effect of those vasoactive agents such as angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and calcium-channel blockers. Angiotensin-receptor and neprilysin inhibitors, though with much fewer trials, seemed to be even more potent. It is probably relevant to mount a randomized controlled trial to compare these newer with older antihypertensive agents in treating central hypertension or central uncontrolled hypertension in the effect of central blood pressure control, target organ damage and cardiovascular events.