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.