P4.04 LONG-TERM REDUCTION IN AORTIC STIFFNESS IN HYPERTENSIVE PATIENTS IS PARTLY INDEPENDENT OF MBP REDUCTION

Abstract

Purpose: A decrease in aortic stiffness could theoretically occur after several years of treatment but reduction has never been unequivocally demonstrated in clinical practice. Association with changes in blood pressure remained unclear. Methods: This longitudinal observational study was conducted in 97 patients (63±1 yrs, 47 women) with treated essential hypertension attending the outpatient hypertension clinic at Pompidou Hospital. Aortic stiffness and carotid pulse pressure (CPP) were determined through carotid-femoral PWV and applanation tonometry. The first measurement of PWV was performed when brachial SBP was lowered below 140 mmHg under treatment. 66 patients had 3 PWV measurements, and 31 patients had 2 measurements during an extended follow-up (5.3±1.2 yrs). Results: The reduction in PWV (from 14.2±4.2 to 11.1±2.4m/s, linear mixed model, P<0.0001) was associated with a reduction in central SBP (from 132±2 to 122±2 mmHg, P<0.0001) and central PP (from 59±2 to 54±2, P<0.001), whereas brachial SBP and PP did not significantly change. In multivariate analysis, the decrease in PWV was significantly associated with age (P<0.005), duration of follow-up (P<0.0001), presence of diabetes (P<0.005) and reduction in brachial MBP (P<0.005), independently of gender, changes in brachial PP, glomerular filtration rate and hypercholesterolemia. Conclusion: These results indicate that a large decrease in aortic stiffness (−22%) can be observed in the long term when hypertensive patients were treated under conditions of routine clinical practice. This reduction of aortic stiffness was associated with a reduction in central SBP and PP contrasting with no change in brachial SBP and PP.