Skip to main content
  • Poster Abstract Presentations
  • Open access
  • Published:

P1.8 Antihypertensive Medicines of Up To 4-Drug Combinations in a Large, Community-Based Study: Differential Relationships with Brachial Blood Pressure and Aortic Waveform Parameters

Abstract

Background

Comparing relationships that antihypertensives have with brachial blood pressure (BP) and aortic waveform parameters helps clinicians to predict the effect on the latter in brachial BP-based antihypertensive therapy. We aimed to make such comparisons with new waveform measures and a wider range of antihypertensive regimens than examined in previous research.

Methods

Cross-sectional analysis of 2915 adults (61% male; aged 50–84 years): 1619 on antihypertensive treatment and 1296 untreated hypertensives. Sixteen medicine regimens of up to 4 combinations of drugs from six antihypertensive classes were analysed. Aortic systolic BP (SBP), augmentation index (AIx), excess pressure integral, reflection index (RI), backward pressure amplitude (Pb) and pulse wave velocity (PWV) were calculated from aortic pressure waveforms derived from suprasystolic brachial measurement.

Results

For all regimens, brachial SBP was lower with antihypertensive use. However, while brachial SBP did not differ across the 16 regimens (P=0.17), RI (P<0.0001), Pb (P=0.0001) and AIx (P<0.0001) did. This was predominantly due to beta-blocker associations: forest plots of single-drug class comparisons across regimens with the same number of drugs (for between 1- and 3-drug regimens) revealed that AIx, Pb and RI were higher with the use of a beta-blocker compared with vasodilators and diuretics, despite no differences in brachial SBP. Compared to those untreated, beta-blocker use was associated with greater percentage differences in brachial BP than aortic waveform parameters.

Conclusions

Beta-blocker use has weaker associations with wave reflection measures than brachial SBP, suggesting that effects on these may be overestimated with brachial BP-based antihypertensive therapy.

Author information

Authors and Affiliations

Authors

Rights and permissions

This is an open access article distributed under the CC BY-NC license http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sluyter, J., Hughes, A., Lowe, A. et al. P1.8 Antihypertensive Medicines of Up To 4-Drug Combinations in a Large, Community-Based Study: Differential Relationships with Brachial Blood Pressure and Aortic Waveform Parameters. Artery Res 8, 131 (2014). https://doi.org/10.1016/j.artres.2014.09.089

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1016/j.artres.2014.09.089