DETERMINANTS OF ELASTIC AND STIFFENING PULSE PRESSURE COMPONENTS: RESULTS OF THE NEW HUNGARIAN ABPM REGISTRY

Abstract

Objective: Pulse pressure (PP) received relative less attention in the guidelines regarding its potential role in the hypertension-mediated target organ damage. Recently it has been proposed that PP can be divided into two components: elastic PP (elPP) and stiffening PP (stPP). Thus the aim of our study was to explore the determinants of 24-hour, daytime and nighttime elPP and stPP in a new national ambulatory blood pressure monitoring (ABPM) database. Design and method: ABPM data were collected from the Hungarian ABPM Registry between February 2021 and August 2022. The Hungarian ABPM Registry is a an ongoing multicenter, open-label, observational non-interventional study. Meditech ABPM-06 monitors were used for ABPM measurements. Basic patients’ data were documented in electronic case report forms and were later analyzed together with ABPM data. elPP and stPP were calculated according to Gavish et al (DOI:10.1097/HJH.0000000000003258). Results: 14817 ABPM data were analyzed. The average age of the subjects was 55.29 ± 15.1 years, 7845 (48.9%) of them were men. 24h, daytime and nighttime elPP were 47.42 ± 8.89, 46.45 ± 9.34 and 45.93 ± 10.94 mmHg, respectively. 24h, daytime and nighttime stPP were 8.51 ± 5.86, 9.15 ±6.56 and 8.62 ± 7.81 mmHg, respectively. Under the age of 50 years all elPPs were significantly lower in women compared to men, while all stPPs were lower in both sexes in age under 50 (p<0.05). Independently from age and sex, obesity increased all elPPs, while under the age of 50 years nighttime stPP was elevated only in obese women (p<0.05). The independent determinants of daytime and nighttime elPPs were age, systolic blood pressure (sBP), obesity and diabetes with adding ischemic heart disease in case of 24h elPP. The independent determinants of 24h and daytime stPPs were age, sBP and diabetes, while in case of nighttime stPP age, sBP and sex. Conclusions: The new Hungarian ABPM Registry underline the importance of PP and its elastic and stiffening components. The evaluation of their determinants can help to better understand the pathomechanisms responsible for the development of hypertension-mediated target organ damage.