PP.17.28

Abstract

Objective: To determine the relationship between the arterial pressure (AP) variability (VB) obtained through blood AP measurement in the clinics (VBCLIN), the VB estimated with 24 h ambulatory monitoring of AP (MAPA) (VBMAPA) and home automonitoring of AP -AMPA- (VBAMPA) in the presence of vascular target organ damage (TOD). Design and method: Descriptive study assessed with 91 hypertensive patients in treatment and stable with AP<160/100 mmHg. Patients between 50–60 years old were included. VBCLIN was estimated from 8 measurements per week. A 24 h MAPA was assessed to all the patients included in the study in order to obtain the VBMAPA and an AMPA in two non consecutive weeks to obtain the VBAMPA (total of 54 measurements). Results: 91 patients with 66 ± 7.7 years old. The vascular TOD prevalence was 38.5% according to PWV>10 m/s, 22% with ABI<0.9 and 30.4% with an ITM >0.9 mm and/or plaque presence. The VBCLIN of the systolic AP was associated with a lower ABI (p = 0.01) and negatively correlates with ABI (r = -0.25; p = 0.02) and positively with ITM (r = 0.3; p = 0.006). The VBCLIN of the diastolic AP was also associated with a lower ABI (p = 0.007) and a higher ITM (p = 0.02), which also showed an inverse correlation with ABI (r = -0.33; p = 0.002) and positive with ITM (r = 0.3; p = 0.006). The VBAMPA of the systolic AP was associated with an increased PWV (p = 0.007) and correlated with ITM (r = 0.23, p = 0.02). The VBMAPA of the systolic AP was also positively correlated with ITM (r = 0.25; p = 0.02). ROC analysis found that the VB of the systolic AP estimated in the clinics, AMPA or MAPA properly predicts the presence of a pathological ITM with an area under the curve of 0.66 for VBCLIN (p = 0.014), 0.67 for VBAMPA (p = 0.008) and 0.68 for VBMAPA (p = 0.006). The area under the curves for pathological ABI and PWV from VB of the AP were not statistically significant. Conclusions: The current study reports that a higher VB (estimated any method) is associated with a higher vascular DOD. Besides, the VB of the systolic AP with the three different methods predicts the presence of a pathological ITM.