Impedance cardiography evaluation in elderly hypertensive patients

Abstract

ObjectivesVascular aging results from endothelial dysfunction and increased arterial stiffness, a independent determinant of cardiovascular (CV) events, that is amplified by the presence and progression of arterial hypertension (AH). Age related changes in hemodynamic variables1 may predict negative vascular outcomes.2 In this study, we evaluate hemodynamic variables in elderly hypertensive patients with impedance cardiography (IC) in order to infer opportunities for therapeutic optimization.MethodsWe retrospectively analysed hypertensive patients that were purposed for IC evaluation. The selected 75 patients were divided into two groups, above or below 65 years old, matched by anthropometric and blood pressure (BP) values. (Table 1) Antihypertensive therapy wasn’t considered. For each group the mean of IC variables was obtained, and statistical analysis was performed by a T-student test.ResultsFrom the patients included, 25 have ≥65 years and 50 <65 years. In the elderly group mean age was 71 years, 52% were female and mean BMI 28,6 Kg/m2. Mean BP was 142 mmHg vs 135 mmHg for systolic and 74 mmHg vs 83 mmHg for diastolic BP, heart rate 63 bpm vs 69 bpm in elderly and younger group respectively. Mean IC results showed statistically significance differences for cardiac output, cardiac index, systemic compliance, left ventricular ejection time, velocity index and acceleration index between the groups. (Table 2)ConclusionsBP determination and control may not signify adequate hemodynamic state. With this study, elderly hypertensive patients present different hemodynamic behaviour, compared with younger ones, in variables of blood flow, resistance and contractility. These data could have potential implications on the pharmacological optimization of BP treatment.