Abstract P358: Central BP Variability is Increased in Hypertensive-related Target Organ Damage

Abstract

Peripheral BP variability (BPV) has been found to be increased in hypertensives with target organ damage (TOD). It is unknown if central BP variability follows the same pattern. We aimed to evaluate short-term BPV in a group of hypertensive subjects classified as having or not cardiac, renal, or vascular TOD. A total of 178 hypertensives (33% women; age 57±12) were evaluated. TOD was defined by the presence of left ventricular hypertrophy (LVH) on echocardiography, renal alterations (urinary albumin excretion >30mg/g or eGFR < 60 ml/min/1.73m 2 ) or aortic stiffness (aortic pulse wave velocity > 10 m/s). BPV was estimated by 24-hour peripheral and central BP monitoring. Parameters evaluated included: night-to-day ratios (NDR), standard deviation (SD) and coefficient of variation (CV) for 24 hours, day and night, weighted standard deviation (WSD) and average real variability (ARV). Ninety-two patients (51.7%) had TOD, distributed as follows: 66 (37.1%) had LVH, 47 (26.4%) had renal alterations, and 37 (20.8%) increased aortic stiffness. Systolic and diastolic night-to-day ratios and systolic BPV were increased in patients with TOD with respect to those without (table). No differences were observed in diastolic BPV. The increase in systolic BPV was also observed when comparing groups with or without LVH, renal damage or aortic stiffness. Brachial BPV exhibited the same increased variability as central BPV. We conclude that the presence of hypertensive cardiac, renal or vascular organ damage is associated with increased systolic central BPV and reduced systolic and diastolic nocturnal fall in BP. Central BPV follows the same pattern as observed with peripheral BPV.