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P5.8 Mismatch Between Office Blood Pressure Response and Hemodynamic Parameters in Routine Treatment of Hypertensive Patients

Abstract

Rationale

Control of hypertension has been recently improved by means of the rational use of non invasive haemodynamics (NIH). It is specially useful in resistant hypertension and particularly leads to a better BP control, less use of drugs and improved quality of life. Most of these knowledge was obtained from PROBE trials, but as NIH is not available routinely in clinical practice it is very important to understand what happens in real life controlling BP according to current guidelines.

Methods

We started to use NIH since January 2011 and we analyzed 1301 patients evaluated up to December 2012 using Z Logic ®, an analog of Minesota impedance cardiograph. Seventy five patients underwent repeated evaluations in similar conditions, and we compared data from both situations, in fasted resting patients at through of CV medication.

Results

See attached table. A non significative reduction of BP was observed, 19 pts. (25%) improved BP control, 6 (8%) worsened and 50 (67%) showed no change. Small and non significative changes were observed in the number and type of drugs. In the improved patients there was a significative reduction of BP and HR without significant changes in haemodynamics.

Conclusion

These results can be explained by an initial lack of experience in the use of the NIH to treat hypertensive patients. When NIH is not taken into account, a large proportion of patients remain uncontrolled and the underlying haemodynamic pattern could explain the lack of effective BP control. Even in those controlled, still persist haemodynamic disturbances.

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Forcada, P., Castellaro, C., Gonzalez, S. et al. P5.8 Mismatch Between Office Blood Pressure Response and Hemodynamic Parameters in Routine Treatment of Hypertensive Patients. Artery Res 8, 144 (2014). https://doi.org/10.1016/j.artres.2014.09.145

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.145