PS 08-20 HOME BLOOD PRESSURE VARIABILITY REFLECTS ARTERIAL STIFFNESS IN ELDERLY HYPERTENSIVE PATIENTS TREATED WITH ANTIHYPERTENSIVE MEDICATION.

Abstract

Recently, it is recognized that blood pressure variability is an important predictor of cardiovascular diseases in hypertensive patients as well as absolute value of blood pressure. Vascular sclerosis by aging increases blood pressure variability in elderly hypertensive patients. In this study, we investigated the correlation between circadian variability in home blood pressure (BP), vascular sclerosis and urinary albumin excretion of elderly hypertensive patients with antihypertensive drugs including amlodipine.

This prospective study included elderly 26 Japanese patients with essential hypertension over age 65 (mean age: 71 ± 6.2). During consecutive 28days, the patients measured home BP twice a day (early morning and night (before sleep)) at least each three occasions with an electronic sphygmomanometer (MEDICAL LINK, OMRON) according to the Japanese hypertension guideline. We calculated the average and variability (CV (coefficient of variation) = SD/mean) of the blood pressure. We used Brachial-ankle pulse wave velocity (baPWV) as a marker of arterial stiffness. We measured urine albumin to creatinine ratio at the end of the study. Data are expressed as mean ± SD.

Averages home BP in the morning and at night were 128.5 ± 8.3/79.4 ± 4.8mmHg and 124.1 ± 10.0/72.3 ± 5.3mmHg, respectively. The BP average of the both early morning and before sleep were not correlated to baPWV, urine albumin and pulse pressure. The home BP variability correlated to baPWV (systolic CV (morning); R = 0.498, p < 0.01, (night);R = 0.597, p < 0.01, diastolic CV (night);R = 0.578, p < 0.01). Pulse pressure positively correlated to baPWV (moning); R = 0.498, p < 0.01, (night);R = 0.598, p < 0.01). BP variabilities correlated to urine albumin (systolic CV (morning); R = 0.425, p < 0.05, diastolic CV (night);R = 0.456, p < 0.05) and urine albumin correlates to baPWV (R = 0.721, p < 0.01).

Our results suggest that increased home BP variability reflects vascular sclerosis and renal injury in elderly hypertensive patients with successful BP control.