P124 Central Blood Pressure Measurement: Paradigm Shift

Abstract

Introduction

It is estimated that currently 17 million deaths annually in the world occur due to cardiovascular disease (CV), about one third of all deaths. 9.4 million are related to arterial hypertension (HA). The use of methods that allow the early identification of structural and functional cardiovascular alterations can improve the strategy of treatment and control of these patients.

Description

LSO, 65 years old, female, white. Ringing in the ear and headache. Hypertension for 18 years and panic syndrome using Candesartan 8 mg, Fluoxetine 20 mg and Alprazolan 0.5 mg. In 06-2016, presenting blood pressure (BP):172 × 104 mmHg. Candesartan was elevated to 16 mg, initiating Rosuvastatin 10mg (C-reactive protein:16 and LDL-C:142), targeted improvement of lifestyle habits. ABPM 2 weeks after normal. Returned on 10-2017 with tachycardia and dizziness. She stopped Fluoxetine and Rosuvastatin. BP:178 × 84 mmHg. Reintroduced Fluoxetine and Rosuvastatin with new normal ABPM. Returned in 02-2018 with feeling of death, uneasiness and palpitations. BP:138 × 78 mmHg and normal ECG, in regular use of the medications. Accomplished non - invasive central blood pressure measurement (Mobil O’Graph) with arterial stiffness elevation, central AP:143 mmHg and augmentation index (AI):50 was performed. Felodipine -2.5 mg was started even with the new normal ABPM. 4 months later new measures with central BP:128 and AI = 33-table 1.

Conclusion

The treatment of HA depends on the choice of the drug and early onset with reduction of BP and CV outcomes 3,4. The central BP has greater relevance in the reduction of BP and cardiovascular outcomes than the peripheral BP 5,6. Keywords: Hypertension; Central Blood Pressure; Arterial Stiffness.

Table 1