[OP.LB03.01] CENTRAL BLOOD PRESSURE AND SALT INTAKE IN A POPULATION COHORT FROM A HIGH STROKE INCIDENCE AREA – THE GUIMARÃES/VIZELA STUDY

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Abstract

Objective:

The value of central blood pressure (CBP) over peripheral blood pressure is under debate, i.e. concerning its independent predictive power for cardiovascular (CV) events / target organ damage (TOD) and its use as a therapeutic target.

Objectives:

To characterize the distribution of CBP values in a population residing in an area of high stroke incidence through comparison with published reference values for healthy subjects; to identify subjects at higher CV risk; to analyze the influence of salt intake on CBP, and to assess whether CBP plays a role in risk stratification and treatment.

Design and method:

A longitudinal cohort study, evaluated a representative random sample of the adult population of two adjacent cities, in a two visit study plan, including CBP measurements, TOD evaluation and 24 h urine sampling.

Results:

2542 subjects completed the study (average 45 years; 55% female). Central systolic blood pressure (CSBP) and Central Pulse Pressure (CPP) presented mean values of 119.2 and 41.8 mmHg, respectively; several age groups registered mean values of CSBP/CPP exceeding 10 - 20 mmHg the expected for healthy subjects. Central Pulse Pressure Amplification (CPPA), registered a mean ratio of 1.32. 37.5% of the general population and 72.4% of hypertensives presented CSBP >90th percentile (90 thp); CPP >90 thp was registered in 23.7% of the general population and in 51.5% of hypertensives. In treated and controlled hypertensives, 33.9%/20.5% of the subjects persisted with CSBP/CPP values >90 thp, respectively. TOD was significantly more prevalent in subjects above CSBP/CPP 90 thp (2 to 4 times). Salt intake was an independent explanatory variable of CSBP (p = 0.038) and CPPA (p = 0.026) in multivariate regression analysis, and it increased the risk of having CSBP >90 thp (p = 0.048).

Conclusions:

High central SBP values, and associated TOD, were found in an area of high stroke incidence. In all, 33.9% of controlled hypertensives maintained significantly elevated CSBP, and salt intake emerged as an independent determinant of CSBP and CPPA

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