CO-31: Prevalence of asymmetrical blood pressure in uncontrolled hypertensive patients is high and highly related with cardiovascular diseases prevalence

Abstract

Background A meta-analyse published in the Lancet has shown that an asymetry of the blood Pressure between arm of more than 15 mmHg and perhaps of 10 mmHg and more is associated with an increase of cardiovascular diseases and that a greater attention should be paid to it (Clark CE et al. Lancet 2012;379:905–14). These data need to be confirmed in daily practice. Objectives To describe the prevalence of the asymmetrical blood pressure (ABP) in patients presenting an uncontrolled blood pressure (BP) under treatment. Secondary objectives: To identify factors influencing its prevalence and evaluate its relation with the frequency of the cardiovascular diseases presented by the patients. Methods Observational cross sectional study conducted in daily community medical practice. Inclusion criteria: patients presenting uncontrolled BP according ESC criteria by a previous antihypertensive therapy. Measurements: ABP was measured at each arm according ESH/ESC Clinical Practice Guideline. Statistical analysis: multiple regression analysis (MRA) adjusted on cardiovascular risk factors (CVRF). Results Among 2417 hypertensive patients, 63,3 ± 11,0 years old, 36,8% (IC95% [34,9; 38,7]) were presenting a between-arm difference in systolic blood pressure > = 10mmHg, and 17,1% (IC95% [15,6; 18,6]) > = 15mmHg. MRA shows ABP (> = 10mmHg) prevalence was influenced by dyslipidemia (OR: 1,5 [1,2; 1,7] p = 10mmHg influences the frequency of sub clinical impairment of target organ (OR: 1.6 [1.3; 1.9] p = 15mmHg (OR: 1.6 [1.1; 2.4] p Conclusions In uncontrolled hypertensive patients, a greater intention should be paid to the screening of an asymmetrical blood pressure that should help to identify clinically high risk cardiovascular patients or patients with subclinical organs damages.