10. THE USEFULNESS OF ESTIMATED CAROTID SYSTOLIC BLOOD PRESSURE USING FORM PWV/ABI IN BLOOD PRESSURE LOWERING THERAPY

Abstract

Background: Central systolic blood pressure (central-SBP) can be estimated noninvasively and antihypertensive drugs may exert different effects on central-SBP. We investigated the usefulness of carotid systolic blood pressure (carotid-SBP) estimated by form PWV/ABI in blood pressure lowering therapy. Methods: We evaluated pulse wave velocity, carotid augmentation index (AI), carotid-SBP in 329 patients (301 hypertensives, 172 men, 65±12 yeasrs old) using form PWV/ABI. Antihypertensive drugs were evaluated in those patients. Results: Mean brachial blood pressure (b-SBP) was 136±21 mmHg and carotid-SBP was 147±25 mmHg. We determined delta-SBP as carotid-SBP - b-SBP, and we divided the subjects into group A (delta-SBP<0mmHg) and group B (delta-SBP>0mmHg). The number of group A was 22 patients and that of group B was 307 patients. There were no differences of mean age between these two groups. Although b-SBP of group A (137±21 mmHg) was similar to that of group B (136±21 mmHg), b-diastolic BP of group A (83±12mmHg) was different from that of group B (77±13 mmHg, p=0.0456). Carotid AI of group A (13±14%) is lower than that of group B (23±18%, p=0.0160). The evaluation of the effect of antihypertensive agents showed that Ca antagonists, angiotensin receptor blockers, angiotensin converting enzyme inhibitors and diuretics did not affect delta-SBP significantly. However, those who had β blockers or blockers showed higher delta-SBP compared to those who without these drugs. Conclusion: Estimation of carotid-SBP using form PWV/ABI is useful for the evaluation of the effects of antihypertensive drugs on brachial and central BPs.