Abstract 104: Amplification of Systolic Blood Pressure and Pulse Pressure is Higher in Resistant Hypertensive Patients Irrespective of Blood Pressure Control

Abstract

Background: Systolic blood pressure (SBP) is higher in peripheral than in central arteries, a phenomenon referred to as BP amplification. A greater amplification of SBP and pulse pressure (PP) is associated with increased cardiovascular disease (CVD). The objective of this study is to investigate whether BP amplification is different in patients with uncontrolled resistant hypertension (uRHTN) when compared to those with controlled RHTN (cRHTN) and controlled non-RHTN (cnRHTN). Methods: In this prospective study, 149 patients were recruited from The University of Alabama at Birmingham’s HTN clinic. Brachial BP was measured using in-office BpTRU. Aortic BP was determined using pulse wave analysis by SpygmoCor. BP amplification was calculated as the difference between brachial and aortic BP. Results: The cohort comprised 50.0% women and 53.6% African Americans. Mean baseline values were: age 58.6 ± 10.3 years, BMI 34.2 ± 6.7 Kg/m 2 , SBP amplification 11.0 ± 4.4 mmHg and PP amplification 12.0 ± 4.7 mmHg. Multiple regression analysis showed a significant correlation of gender and increasing BMI with amplification of SBP (p<0.0001 and 0.003, respectively) and PP (p=0.001 and 0.007, respectively). Amplification of SBP and PP were significantly higher in patients with uRHTN compared to patients with cRHTN and similarly, patients with cRHTN had higher amplification than those with cnRHTN (p=0.046 and 0.021, respectively). Conclusion: This prospective study showed that the amplification of SBP and PP remains high in patients with RHTN regardless of BP control, indicating that patients with RHTN retain a higher risk of CVD morbidity and mortality in spite of successful BP control.