Introduction: Central blood pressure BP could be a better method to assess risk related to BP because it predicts mortality independent of brachial BP. This current study is the first randomized trial to test the usefulness of central BP as a management tool for doctors treating patients with hypertension.

Methods: Participants with uncomplicated essential hypertension (n=284) were randomized to 12 months of treatment decisions guided by usual care (based on office, home and 24 hour ambulatory brachial BP) or, in addition, by central BP estimated using radial tonometry (based on age and sex-specific normal central systolic SBP values). Recommendations regarding titration of antihypertensive medication (increase, decrease or maintain dose) were provided to each participant and their general practitioner. Relevant clinical information (e.g. co-morbidities, LV mass, blood biochemistry and BP-related symptoms) were considered when making titration recommendations in all participants. The primary outcome measures are: 1) change in LV mass (by real time three dimensional echocardiography); 2) amount of medication used; and 3) quality of life. Analysis will be by intention to treat.

Results: Recruitment began in January 2008 and will be completed in June 2012. It is hypothesized that there will be no significant difference in LV mass between groups. However, there will be significantly reduced use of medication and improved quality of life in the central BP group because more appropriate titration choices will be made to maintain normal central SBP.

Conclusion: Principal findings will be presented at ARTERY 12.