PP.03.28

Abstract

Objective: Emerging evidence now suggests that central pressure is better related to future cardiovascular events than brachial pressure. Visit-to-visit systolic blood pressure variability (SBPV) in treated hypertensive patients has adverse impact on prognosis and it stimulates searching for its predictors. The aim of the study was to evaluate SBPV and its associations with central blood pressure and arterial stiffness in controlled arterial hypertension. Design and method: 52 pts (20 men, age 58,9 ± 9,0 yrs; 4 smokers; 6 diabetics) were treated to target BP < 140/90mmHg with a RAAS-inhibitor/amlodipine combination for 14 months. Baseline BP was 163,4 ± 8,1/100,9 ± 4,2mmHg; achieved-123,7 ± 9,7/76,8 ± 6,7mmHg. SBPV was calculated as SD for 5 visits during 8 months after target BP achievement. Central BP and pulse wave velocity (PWV) were measured at baseline and in 14 months. p < 0,05 was considered significant. Results: SBPV range was 1,79–16,79 mmHg (tertile I < 5,38; II 5,38 - 7,78; III > 7,78 mmHg). The groups were similar by age (I 56,6 ± 8,94, II 59,4 ± 9, III 60,7 ± 9,1 yrs, p > 0,05), gender, metabolic risk factors, baseline and achieved BP (I 162,9 ± 8,7; II 164,0 ± 9,0; III 163,4 ± 7,0 mm Hg and I 122,9 ± 7,3; II 126,7 ± 8,8; III 121,6 ± 12,1 mm Hg, respectively). Higher SBPV was associated with higher baseline central SBP (I 134,6 ± 15,8; II 132,6 ± 15,9 and III 146,1 ± 17,7 mm Hg) and higher baseline central PP (47,2 ± 10,6, 55,6 ± 11, 51,1 ± 11,5 mmHg, respectively), p < 0,05 for both trends. Number of patients with baseline central SBP>Median (140 mmHg) was 66,7%, 35,3% and 41,2% for corresponding tertiles of SBPV (Pearson‘s χ2 = 4,9; p < 0,05) No correlation was found between SBPV and any other characteristics, including baseline central SBP. No significant difference was found for PWV (13 ± 1,6, 14,2 ± 2,2, 12,9 ± 1,8 m/s, respectively). Conclusions: Higher central SBP and PP despite similar levels of brachial BP may predict higher visit-to-visit SBPV in controlled hypertension. This finding confirms possible association of BPV and arterial stiffness and remodelling.