P42: 24-Hour Central Blood Pressure is More Strongly associated to Target Organ Damage Than Brachial Blood Pressure: First Results of the Vasotens Registry

Abstract

Objective

In the present analysis of the VASOTENS study [1] baseline data, we checked whether organ damage of hypertension (TOD) i) is better associated with 24-hour central than peripheral BP and ii) is related to ambulatory arterial stiffness, estimated by pulse wave velocity (PWV) and augmentation index (AIx).

Methods

TOD in 334 hypertensive patients (mean age 53 ± 15, 52% males, 45% treated) was estimated by calculation of left ventricular mass index (LVMI), intima-media thickness (IMT) and creatinine clearance (CC). 24-hour indices were estimated through the Vasotens technology [2]. 24-hour brachial (bSBP) and aortic systolic BP (aSBP), standard deviation of bSBP, PWV and AIx were obtained. Bivariate and multivariate analysis (stepwise linear regression) was used.

Results

A significant relation was found for age, bSBP and aSBP vs. LVMI and IMT (see table). IMT was also significantly related to SBP variability and arterial stiffness, whereas age, SBP variability and AIx were significantly associated with CC. In the multivariate analysis, including all ••••variables entered in the bivariate model, adjusted by sex, statistically significant (p < 0.001) association was observed for aSBP and age with LVMI (standardized regression coefficient 0.25 and 0.18, respectively), and for age with IMT (0.56) and CC (−0.53).

Table 1

Conclusions

In hypertensive patients age appears to be the major determinant of TOD, with central SBP, and marginally peripheral SBP, PWV and AIx, also playing a significant role. Our results suggest that estimation of 24-hour central hemodynamics and arterial stiffness in ambulatory conditions may help improve the individualized assessment of the BP-associated TOD.