PP.03.12] SIGNIFICANT INTER-ARM DIFFERENCE IN BLOOD PRESSURE IS ASSOCIATED WITH INCREASED ARTERIAL STIFFNESS AND ABDOMINAL OBESITY IN VERY ELDERLY HYPERTENSIVES

Abstract

Objective: Inter-arm difference in blood pressure (BP) and orthostatic BP response have important prognostic significance in hypertensive patients. However, data on prevalence, predictors and clinical associations of those phenomena are controversial. The aim was to investigate inter-arm difference, orthostatic response and to establish their clinical associations in very elderly hypertensives. Design and method: 67 hypertensive subjects older than 80 years (mean age 84,1 ± 3,1 years, 25,5% male, mean clinic brachial SBP 134,8 ± 23,2 mm Hg) were included in cross-sectional study. Simultaneous bilateral brachial BP measurements were performed using oscillometric validated cuff-based device in supine position and then after 2 minutes of standing. Central pulse waveform characteristics and arterial stiffness parameters were estimated by BPLab Vasotens system. Results: The median of inter-arm difference in SBP (IADSBP) was 4,00 (2,5; 9,0) mm Hg. 25,4% participants had IADSBP of 10 mm Hg and more. Compared to others, those with IADSBP of 10 mmHg and more had significantly higher body mass index (31,4 ± 5,7 vs 28,5 ± 4,1 kg/m2, p < 0,05), waist circumference (116,3 ± 13,6 vs 107,7 ± 11,2 cm, p < 0,05) and pulse wave velocity in aorta (11,7 ± 1,5 vs 10,8 ± 1,7 m/s, p < 0,05). Positive correlation between IADSBP and augmentation index was revealed (r = 0,277, p < 0,05). Patients with asymptomatic orthostatic hypotension (OH) (22,4% participants) had higher levels of brachial SBP and pulse pressure (PP) while central BPs and markers of arterial stiffness did not differ from those without OH. Conclusions: Significant IADSBP is associated with increased arterial stiffness and abdominal obesity in very elderly hypertensive patients, whereas there was no evidence of interrelation between orthostatic response and arterial stiffness in such patients