P34 DETERMINANTS OF PERIPHERAL WAVE REFLECTION IN A LARGE TREATED HYPERTENSIVE POPULATION

Abstract

Objective: To evaluate the determinants of the peripherial wave reflection measured by the second derivative of the fingertip photoplethysmogram (SDPTG) among known cardiovascular (CV) risk factors in a large treated hypertensive population. Population and Methods: We studied prospectively 316 hypertensive patients under treatment (154 male, mean age 54 yrs) by SDPTG automatically recorded from the second digit of the right hand (Fukuda FCP-3166®). The SDPTG waveform consisted of a, b, c and d waves in systole and e wave in diastole. The heights of the a, b and d waves were measured from the baseline, and d/a and b/a ratio were calculated. Augmentation index (AUI) was defined as the ratio of the height of the late systolic peak to that of the early systolic peak; SDPTG aging index (AGI) was calculated as (b-c-d-e)/a. The CV risk factors analized were systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), left ventricule mass index (LVMI), creatinine, glycemia, cholesterol, triglycerides and body mass index (BMI). Results: In the multivariate analysis the most signicative associations were: AGI: age (+, p<0,001) and SBP (+, p < 0,05); b/a: age(+, p < 0,001), SBP(+, p < 0,01) and HR(−, p < 0,01 ); , d/a: BP (− , p < 0,01); AUI:SBP( +, p < 0,001), HR(−, p < 0,001 ) and BMI(− , p < 0,01). When compared according BP control (<140/90 mmHg), AUI, b/a and d/a ratio were significantly higher in the patients whose BP was not controlled. Conclusion: In treated hypertensives, changes in vascular wave reflection and stiffness were influenced by age, HR, and blood pressure control, most importantly SBP.