PS-P01-10: MASKED HYPERTENSIVE EFFECT AND GROWTH DIFFERENTIATION FACTOR 15

Abstract

Background: Growth differentiation factor 15 [GDF15], a possible biomarker of mitochondrial function related to ageing was reported to be associated an increased risk of cardiovascular events. However, there were no previous data that investigated the relationship between masked hypertensive effect and serum GDF15 level. Methods: In outpatients clinic in which evaluated frailty in elderly patients, we evaluated clinic, home and 24-hr ambulatory BP, and serum GDF15 level in 116 hypertensive patients. Clinic BP was automatically measured twice in a sitting position [HBP-9035, Fukuda-Colin, Japan]; home BP [HBP], 3 times in the morning and evening for 5 days [HEM-7080IC, Omron, Japan]; and ambulatory BP [ABP], at 30-minute intervals for 24 hours [TM-2441, A&D, Japan]. Results: Mean age was 77.6 ± 7.3 years [male 37.1 percent]. Clinic BP was 132.9 ± 18.7 / 73.9 ± 12.7 mmHg, and pulse rate 77.2 ± 14.4 bpm. GDF15 had a skewed deviation, and median GDF15 was 1.53 [25–75 percentile, 1.25–2.08] ng/ml. Natural log-transformed GDF15 [LnGDF15] was negatively related to clinic BP [systolic BP, r = -0.338, P < 0.001; diastolic BP, r = -0.335, P < 0.001], but not to home systolic BP [r = -0.112, P = 0.252] or awake ambulatory systolic BP [r = -0.080, P = 0.426]. LnGDF15 was significantly related to masked hypertensive effect assessed by ABP [SBP r = 0.273, P = 0.006] and that by home BP [SBP r = 0.382, P < 0.001]. In tertile analysis of GDF15, masked hypertensive effect assessed by ABP and HBP were significantly increased across tertile of GDF15. Masked hypertensive effect was significantly greater across tertile of GDF15 even after adjustment for age, sex, BMI, antihypertensive medication use, diabetes, dyslipidemia, smoking habit, alcohol drinking habit. Conclusion: An increased GDF15 can be associated with an increased masked hypertensive effect in elderly hypertensive patients.