Improvement in blood pressure control with impedance cardiography-guided pharmacologic decision making.

Abstract

Previous reports have demonstrated improvement in blood pressure (BP) control utilizing noninvasive hemodynamic measurements with impedance cardiography (ICG). The purpose of this article is to report the effect of utilizing ICG-guided decision making to treat uncontrolled hypertension in a community generalist setting. Patient medical records were retrospectively reviewed for subjects on two antihypertensive agents with systolic blood pressure > or =140 mm Hg or diastolic blood pressure > or =90 mm Hg. All subjects were treated utilizing a previously published ICG-guided treatment algorithm. Twenty-one subjects met the BP and medication criteria. BP at entry was 157.2+/-13.9/78.7+/-9.9 mm Hg. Subjects were treated for 215+/-85 days (5.0+/-2.0 visits). After ICG-guided treatment, 12/21 (57.1%) achieved sustained BP control (p<0.001). BP was lowered to 141.6+/-22.0 (p<0.001)/77.1+/-10.7 (p>0.05) mm Hg. Antihypertensive agents increased from 2.0+/-0.0 to 2.5+/-0.7 (p<0.05). In this series of subjects with uncontrolled BP taking two antihypertensive agents, ICG-guided pharmacologic decision making resulted in significant reduction in BP and improvement in BP control.