P5.26 24 HOURS PULSATILE HEMODYNAMICS IN BORDERLINE VERSUS RESISTANT HYPERTENSIVES

Abstract

Background: Diurnal variations of brachial blood pressure have important prognostic implications. The aim of this study was to investigate differences in day- and night-time values of brachial and central hemodynamic parameters in two groups of borderline and resistant hypertensives. Methods: We performed 24 hour pulse wave analysis, using a brachial cuff and validated ARCSolver algorithms. Central pressures were derived with a generalized transfer function using measured mean and diastolic pressure for calibration. 50 borderline hypertensives (BH; mean age: 52 years, mean 24h brachial blood pressure (bBP): 123/81 mmHg) and 25 resistant hypertensives (RH; mean age: 58 years, mean 24h bBP: 138/85 mmHg) were included in the study. Day-time was specified as 09:00–21:00 and night-time as 01:00–06:00. Results: With respect to bSBP, we observed a dipping phenomenon (decrease > 10%) in BH, but not in RH. In contrast, with respect to cSBP, no dipping was present in both groups, respectively. Heart rate was significantly lower at night-time in both groups. Daytime and night-time bPP did not differ in both groups, but cPP showed an increase at night-time in both groups. All measures of wave reflection increased at night-time in both groups. Conclusions: Measuring 24h pulsatile central hemodynamic parameters using a cuff device is feasible and can lead to novel insights compared to brachial BP. Further studies should investigate the clinical value. BH RH Brachial systolic BP (mmHg) Day 127* 139$ Night 113 135$ Central systolic BP (mmHg) Day 128 144$ Night 123 147$ Brachial pulse pressure (mmHg) Day 41 51$ Night 40 54$ Central pulse pressure (mmHg) Day 41* 54$ Night 49 64$ Heart rate (bpm) Day 72* 69* Night 59 60 AIx Day 23* 29*$ Night 29 38$ AIx@75 Day 22 25* Night 20 30$ Amplitude backward wave (mmHg) Day 16* 22*$ Night 21 28$ Reflection magnitude Day 61* 64* Night 70 71 *p<0.05 day vs night; $p<0.05 BH vs RH.