12.2 HIGH PULSE WAVE VELOCITY IS ASSOCIATED WITH INCREASED VISIT-TO-VISIT SYSTOLIC BLOOD PRESSURE VARIABILITY IN CONTROLLED ARTERIAL HYPERTENSION

Abstract

Background: Visit-to-visit blood pressure variability (BPV) is associated with adverse cardiovascular outcomes in different patients’ populations1–2. Arterial stiffness is a potential mechanism of increased visit-to-visit BPV3. Carotid–femoral PWV has become increasingly important for total cardiovascular risk estimation. Materials and methods: 52 pts (20 men, age 58.9±9.0 yrs 4 smokers 6 diabetics) were treated to target BP<140/90mmHg with a RAAS-inhibitor/amlodipine combination for 14 months. Baseline brachial BP was 163.4±8.1/100.9±4.2mmHg achieved-123.7±9.7/76.8±6.7mmHg. Central BP and PWV were measured at baseline and after 14 months. Individual values of PWV were assessed according to age and BP categories4. BPV was calculated as SD for 5 visits during 8 months after target BP achievement.p<0.05 was considered significant. Results: Baseline central BP was 137.8±17.3/86.6±12.0mmHg, achieved 125.2±13.5/80.3±6.6mmHg (p<0.05). Baseline PWV varied from 7.6 to 19.2 m/s (median 12.2 m/s), achieved – from 9.9 to 17.4 m/s (median 13.4 m/s),p>0.05. Normal values of PWV according to individual reference values were observed in 25.5% of patients (group1, mean PWV 10.0±1.5 m/s), increased – in 74.5% (group2, mean PWV 13.8±2.4 m/s). Groups were similar by age, gender, metabolic risk factors, baseline and achieved BP and visit-to-visit BPV. SBPV range was 1.79–16.79 mmHg (tertile I<5.38 II 5.38 – 7.78 III>7.78 mmHg). Increased PWV value was more often observed in the III tercile of visit-to-visit SBPV (90.3% comparing to 58.8% in tercile I and 73.3% in tercile II, Pearson (χ2)=5.9,p<0.05). Conclusion: Elevation of PWV above individual reference values in patients with uncomplicated AH is associated with higher visit-to-visit SBPV. This finding confirms role of arterial stiffness in visit-to-visit BPV increase.