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P7.5 Phenotyping of Arterial Hypertension by Pulse Wave Velocity and Plasma Renin Activity Measurement

Abstract

Objective

To test K.Kario hypothesis (J Am S Hypertens 2010; 4(5):215–218) that predominant “arterial stiffness” (AS) and “volume-dependent” (V) types of arterial hypertension may exist and thus evaluation of arterial stiffness and volume-dependency status may help to choice between a calcium channel blocker (as “anti-stiffness” drug) and a diuretic (as “anti-volume” drug) to achieve blood pressure (BP) control.

Methods

Pulse wave velocity (PWV, SphygmoCor, AtCor, Australia) and plasma renin activity (PRA, radioimmune assay) were measured in 124 (48 men) untreated hypertensive patients aged 50–65 years (mean 59,6±5,1 years) with GFR CKD-EPI >60 ml/min/1,73 m2. AS-typing was done by individual PWV interpretation (Boutouyrie P., Vermeersch S.J. Eur Heart J 2010;31:2338–2350). PRA <0,65 ng/ml/h was considered as V-type, PRA >0,65 ng/ml/h - as renin (R) type.

Results

V-type was found in 57,3%, R-type in 42,7%, AS-type in 47,6% patients. Isolated (normal PWV) types were observed in 52,4%, isolated R-type was more prevalent (38,7%) than isolated V-type (13,7%). AS+V-type was found in 43,6%, AS+R-type - in 4,0%. It means that 76,1% of patients with V-type had elevated PWV and 91,5% of patients with increased AS are volume-dependent. Multifactor analysis failed to reveal independent predictors of isolated or mixed types, but independent correlation between PRA and PWV (β=−0,45, p<0,001) and pulse pressure amplification (β=0,76, p<0,001) was found.

Conclusion

Significant over-lap in “arterial stiffness” and “volume” types of arterial hypertension agues against possibility of differential choice between a calcium channel blocker and a diuretic for BP lowering guided by evaluation of PWV and PRA

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Pavlova, E., Kotovskaya, Y. & Kobalava, Z. P7.5 Phenotyping of Arterial Hypertension by Pulse Wave Velocity and Plasma Renin Activity Measurement. Artery Res 8, 149 (2014). https://doi.org/10.1016/j.artres.2014.09.167

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.167