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 nighttime as 01:00−06:00.

Table 1

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.

Table 2