PP.37.17] PREVALENCE OF VARIABLES ASSOCIATED WITH ARTERIAL STIFFNESS IN COMMUNAL PHARMACIES OF THE VALENCIAN COMMUNITY (RIVALFAR-STUDY)

Abstract

Objective: Although determination of arterial stiffness is included in ESH-Guidelines as subclinical target organ damage for monitoring patients, stiffness- related variables are rather unknown among medical doctors and pharmacists. This study aims to measure the prevalence of pulse wave velocity (PWV), central arterial pressure (BPc) and Augmentation Index (AIx) in persons attending a communal pharmacy for any reason. Design and method: Cross-sectional, observational, descriptive, non-interventional study in 32 communal pharmacies of the Valencian Community, belonging to SEFAC (Spanish Society of Communal Pharmacies), between November 2015 and April 2016. Stiffness-related variables were measured with a validated device (MOBIL-O-GRAPH, IEM®), according to ESH-recommendations, followed by a 10 items-containing questionnaire and measurement of the waist circumference. Results: During the first month, mean age of the 638 consecutive recruited patients was 56,5 years, the percentage of men was 38,6 %, with a global BMI of 28,5 kg/m2. Brachial and central BP were 127/80 and 116/81 mmHg, PWV and AI were 8,2 m/seg and 22,5 %, respectively. The proportion of patients with increased PWV, defined as an absolute value > 10 m/seg, was 19,6 %. when adjusting to six age-groups, prevalence was 24,1 %, with a concordance rate of both measurements of 75,9 %. Multivariate lineal regression confirmed age (beta = 0,13; CI: 0,125/0,130; p < 0.0001), and brachial BP (beta = 0,03; CI: 0,028/;0,032; p < 0.0001), as the 2 variables with the highest, independent association with PWV, followed by and obesity. In 69,1 % of the cases elevated PWV coincided with high BP values, but in 18,8 % of patients PWV was normal in spite of high BP and in 12,1 % of the cases BP was normal but PWV was pathological, indicating increased CV risk, not recognized by simple BP measurement. Conclusions: This pioneering large scale study measuring arterial stiffness in communal pharmacies shows their capability to contribute to the management of hypertensive patients by identifying subclinical organ lesions as vascular damage in almost one fourth of individuals attending a pharmacy for whatever reasons. Measuring PWV together with BP can therefore be recommended as a strategy to improve monitoring BP and promote adherence to treatment.