P1.27 ARTERIAL RESISTANCE IS REDUCED IN PATIENTS WITH TYPE 2 DIABETES AND RESISTANT HYPERTENSION AFTER A MEDIAN PERIOD OF 6 MONTHS INTENSIFIED ANTIHYPERTENSIVE TREATMENT

Abstract

Objectives: To examine vascular characteristics in patients with type-2-diabetes (T2D) and resistant hypertension (RH) after a median period of 6 months intensified antihypertensive treatment. Methods: Patients were characterized as having RH based on ambulatory blood pressure measurements (ABPMs, Kivex® and Spacelabs®). ABPMs were performed at baseline and at 6 months follow up. Pulse wave velocity was measured using the Sphygmocor® device. Central arterial pressure waves were obtained using radial applanation tonometry and a generalized transfer function. Central flow waves were measured just below the aortic annulus using echocardiography. Pressure and flow waves were analysed in customized software written in Matlab. Results: Data are presented as medians and [interquartile ranges]. Follow-up time was 6 [5;8] months. 34 Patients with RH were included for analysis. The intensified antihypertensive treatment resulted in increased use of RAS blockers with no change in use of other antihypertensive agents (diuretics, calcium channel blockers or aldosterone antagonists). Clinic blood pressure was reduced from 154 [143;164] / 89 [81;94] mmHg to 140 [126;160] / 85 [78;93] mmHg (P<0.04), whereas there was no significant reduction in ABPMs (139 [132;145] /75 [70;79) to 138 [129;148] / 76 [69;82] mmHg). After statistical adjustment PWV and characteristic impedance did not change. Arterial resistance was significantly decreased even after adjustment including pulse pressure (See table). Characteristic Baseline Follow up Pulse wave velocity (m/s) 10.8 [8.8;12.2] 9.9 [8.4;13.1] Characteristic impedance (mmHg/mL) 0.1 [0.07;0.13] 0.08 [0.07;0.12] Total arterial resistance (mmHg/(mL/s)) 1.53 [1.34;1.87] 1.46 [1.19;1.79]* Table legend: Vascular characteristics in patients with T2D and RH. “*”Statistical significant change from baseline after adjustment for changes in heart rate, mean arterial pressure or pulse pressure if appropriate. Conclusion: We conclude that arterial resistance, not arterial stiffness, is reduced in patients with T2D and RH after a median period of 6 months antihypertensive treatment. P1.28 Withdrawn by author