[PP.01.20] SEASONAL DIFFERENCES IN BLOOD PRESSURE PHENOTYPES: EFFICACY OF ANTIHYPERTENSIVE TREATMENT

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Abstract

Objective:

The substantial seasonal (winter [W] vs. summer [S]) difference in cardiovascular mortality and morbidity call for further research of its causes including the blood pressure (BP) phenotypes (BPPh) assessment. The aim of this study was to investigate BPPh in medicated hypertensive patients in W and in S.

Design and method:

The patients from the 2012–2014 database of the two regions of Russian Federation (Ivanovo [Iv] and Saratov [Sa], “northern” and “southern” regions respectively, n = 1630) were selected on the following criteria: antihypertensive treatment for two weeks or more (1–3 drugs), availability of clinical (CBP) and ambulatory BP (ABP) monitoring records in W and in S. BPPh definitions: normotension (NT; CBP<140/90 and ABP24<130/80 and ABPday<135/85 and ABPnight<120/80 mmHg), masked hypertension (MH; CBP<140/90 and ABP24>129/79 and/or ABPday>134/84 and/or ABPnight>119/79 mmHg), uncontrolled hypertension (UH; CBP>140/90 and ABP24>119/79 and/or ABPday>134/84 and/or ABPnight>119/79 mmHg) and white coat hypertension (WCH; CBP>139/89 and ABP24<130/80 and ABPday<135/85 and ABPnight<120/80 mmHg).

Results:

The total number of the patients was 237 in Iv and 245 in Sa: 73% vs. 44% men (p<0.0001), mean age 53.5 ± 9.3 vs. 58.6 ± 11.6 years (p < 0.0001), BMI 28.7 ± 4.3 vs. 28.0 ± 4.5 kg/m2, CBP 121.7 ± 7.9 and 74.4 ± 7.2 vs. 127.5 ± 14.9 and 75.6 ± 10.3 mmHg (p < 0.0001 for systolic BP, SBP), respectively. BPPh in Iv (W/S,%): NT–24/28, MH–66/66, UH–9/6, WCH–1/1 (ns). BPPh in Sa (W/S,%): NT–20/19, MH–37/52, UH–40/28, WCH–3/2 (p = 0.007). NT and MH patients seasonal differences in two regions are in table.

Conclusions:

The high MH prevalence in treated patient with normal CBP in both regions may influence the overall prognosis. The increase of MH prevalence in Sa in S may create a false impression of adequate BP control. Both items identify the need for more intensive use of ABP measurement.

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