A STUDY OF BRACHIAL AND CENTRAL 24HOUR BLOOD PRESSURE VARIABILITY ACROSS DIFFERENT HYPERTENSION PHENOTYPES

Abstract

Objective: Masked hypertensives (MHs) are considered a group of increased cardiovascular risk similar to sustained hypertensives. Brachial short term blood pressure (BP) variability (BPV) has been increasingly related to a higher risk of hypertension-mediated damage. Accordingly, central BP (cBP) has been considered to be more closely associated with target-organ damage. Limited data exists regarding BPV in MHs whereas no study has ever investigated BPV of 24hour cBP in MHs. Therefore, this study aimed to investigate and compare brachial and central BPV measures across different hypertension phenotypes. Design and method: Untreated essential hypertensive patients (UHTs) including MHs and normotensive individuals (NTs) were included in the study. Ambulatory BP was measured with the Mobil-O-Graph device, according to standard guidelines. The BPV parameters including the weighted standard deviation (wSD) and average real variability (ARV) of 24hour brachial and central systolic BP (SBP) and diastolic BP (DBP) were calculated according to a standardized formula based on the ambulatory BP monitoring (ABPM) measurements. Results: A total of 141 participants were studied (49.4±8.6 years; 62.4% males) including 79 UHTs, 22 MHs and 40 NTs. Baseline characteristics were similar between groups. As expected, groups differed significantly in terms of office and ABPM-derived BPs. Remarkably, all markers of 24h brachial BPV and 24h central BPV were comparable between MHs and UHTs and significantly higher compared to NTs (Table 1). Conclusions: Brachial and central BPV parameters in MHs don’t differ compared to UHTs, but are significantly higher compared to NTs. Whether this observation is clinically meaningful in terms of cardiovascular risk and target organ damage prediction, merits further investigation.