P3.19 AORTIC PULSE PRESSURE BETTER PREDICTS INCREASES ARTERIAL STIFFNESS COMPARED TO BRACHIAL AND AMBULATORY MEASUREMENTS

Abstract

Objectives: Hypertension is associated with increased arterial stiffness, which is an independent predictor of cardiovascular risk. Aortic systolic blood pressure (SBP) and/or pulse pressure (PP) better predicts cardiovascular events than peripheral blood pressure. The present study compared the discriminative ability for increased arterial stiffness of aortic BP with ambulatory peripheral BP, with reference to office brachial SBP or PP in never treated hypertensives. Methods: We enrolled 619 consecutive essential hypertensives (mean age 52.2±12.0 years, 325 men). Arterial stiffness was determined with carotid-femoral pulse wave velocity (PWV) using the Complior® device. Aortic pressures were measured using the Sphygmocor® device and 24h ambulatory SBP and PP were obtained from 24h ambulatory blood pressure monitoring. We employed dichotomous outcome variable (PWV≥75th percentile [8.55 m/s]). Receiver operating characteristic (ROC) curves were generated to evaluate the ability of the pressures to discriminate subjects with and without significant arterial stiffness (PWV ≥75th percentile [8.55 m/s]). Results: All different types of blood pressure significantly discriminated subjects with significant arterial stiffness (all p<0.001). Aortic pulse pressure had the highest area under the curve (AUC=0.741) and 24h ambulatory SBP the lowest (AUC=0.655). (Figure, Table). Conclusions: PP is more valuable than SBP pressure in the prediction of increased arterial stiffness. Moreover, aortic PP may better predict increased arterial stiffness than brachial or ambulatory BP measurements. Variable AUC 95% CI Aortic pulse pressure 0.741*†‡ 0.696–0.786 Aortic systolic blood pressure 0.717*† 0.672–0.762 Brachial pulse pressure 0.710* 0.664–0.756 Brachial systolic blood pressure 0.681*¶ 0.634–0.727 24h ambulatory pulse pressure 0.705*† 0.657–0.753 24h ambulatory systolic blood pressure 0.655*#¶§ 0.605–0.705 *P<0.001 compared to the null hypothesis that the AUC is 0.5 and the examined variables cannot discriminate subjects with low or high pulse wave velocity values. †P<0.05 compared to 24h ambulatory systolic blood pressure #P<0.05 compared to 24h ambulatory pulse pressure. ‡P<0.05 compared to brachial systolic blood pressure. ¶P<0.05 compared to aortic pulse pressure. §P<0.05 compared to aortic systolic blood pressure.