PP.19.28

Abstract

Objective: To compare target office (<140/90mmHg) and normal home (<135/85mmHg) blood pressure (BP) attainment after 6 month (M) standardized algorithmic treatment and home BP monitoring (HBPM) of normal weight, overweight and obese uncomplicated hypertensives (UH) in longitudinal real-life BP control program. Design and method: Per protocol cohort of PERFECT-BP prospective observational study (ISRCTN75706523) included 430 patients (pts) < 75 years (57.6 ± 0.5years) newly diagnosed (18,3%) or treated but uncontrolled (BP < 200/120 mmHg) UH. Pts and MDs (54 ambulatory cardiologists) were provided with standardized precalibrated automatic BP measurement devices with individually selected and universal cuff correspondingly. At visit 1, pts were given training and written instructions for HBPM and recording (twice per day for 7 consecutive days before each visit at day 7, M1, 2, 3, 6) and were prescribed or switched to perindopril/amlodipine fixed-dose combination (FDC) (doses at discretion of MDs). Step 2 was FDC uptitration, step 3 – plus indapamid-SR, step 4 – spironolactone, step 5 – moxonidine or doxasosine. Results: Of participants, 33(7,7%) were normal weight, 190(44,2%) overweight and 195(45,3%) obese, data of 12(2,8%) pts were missed. Normal weight, overweight and obese pts did not differ in age, office systolic and diastolic BP level at baseline (165,4 ± 2,8; 165 ± 1,0; 166,7 ± 1,0mmHg and 97,9 ± 1,9; 96,8 ± 0,7; 97,6 ± 0,6mmHg respectively, all p > 0,05), but obese group compared to overweight had more females (118(60,5%) vs 90(47,4%), p < 0,05) and diabetics (47(24,1%) vs 13(6,8%), p < 0,01). At 6 M target office BP was attained in 25(75,8%), 159(83,7%), 157(80,5%) pts, normal home BP – in 21(63,6%), 131(68,9%), 118(60,5%) pts, both target office and normal home BP – in 21(63,6%), 123(64,7%), 110(56,4%) pts respectively (all p > 0,05). Among obese 76(39%) pts needed 3 or more drugs vs 5(15,1%) normal weight and 51(26,9%) overweight ones (all p < 0,05). Obese pts had higher office (132,5 ± 0,6 vs 129,2 ± 0,7mmHg, p < 0,05) and home (130,5 ± 0,6 vs 128,1 ± 0,6mmHg, p < 0,05) systolic BP at 6 M then overweight ones. Conclusions: Weight status of UH didn’t influence on 6 M results of standardized algorithmic treatment with HBPM for both office and home BP control, but obese pts required more antihypertensive medications compared to normal weight and overweight ones with similar baseline BP levels.