P8.6 PULSATILE COMPONENT OF CENTRAL BLOOD PRESSURE AND THE RISK OF STROKE IN CORONARY PATIENTS. RESULTS FROM THE AORTIC BLOOD PRESSURE AND SURVIVAL STUDY

Abstract

Background: There is ongoing debate concerning the best blood pressure (BP) parameter predicting cardiovascular risk. The aim of the analysis was to investigate the relationship between central BP and stroke in patients undergoing coronary angiography. Methods: The study group consisted of 954 patients (691 men and 263 women; mean age: 57.3±10.0 years) undergoing coronary angiography with left ventricular EF≥40%. A vast majority of participants was prescribed BP-lowering drugs. Invasive ascending aortic BP during catheterization was taken at baseline. The duration of follow-up was 53.4±18.8 months. We defined pulsatility as the ratio of pulse pressure to mean BP. The Cox proportional hazard regression analysis was used to assess the relation between BP-derived indices and the risk of stroke. Results: During the follow-up 19 (2.0%) patients suffered from stroke and 57 (6.0%) from stroke or CV death. The multivariate hazard ratios related to BP-derived indices according to the presence of HT are given in the table. BP – related variables Stroke CV death or stroke Systolic blood pressure per SD 1.32(0.85–2.04) 1.05(0.79–1.38) Diastolic blood pressure per SD 0.88(0.57–1.36) 0.80(0.61–1.05) Mean blood pressure per SD 1.08(0.71–1.64) 0.91(0.70–1.19) Pulse pressure per SD 1.65(1.03–2.66) 1.25(0.93–1.67) Pulsatility per SD 2.07(1.25–3.42) 1.50(1.11–2.03) Conclusion: Pulsatile, but not steady component of central blood pressure predicts the risk of stroke in coronary patients.