[PP.28.06] DAY AND NIGHT PULSE PRESSURE AMPLIFICATION IN NORMOTENSIVE, HYPERTENSIVE DIPPER AND HYPERTENSIVE NON-DIPPER PATIENTS

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Abstract

Objective:

Several studies have shown that office central blood pressure (cBP) might better predict cardiovascular events than standard peripheral pressure. Recent ambulatory monitoring technologies such as the BPLab monitor equipped with Vasotens software (OOO Petr Telegin, Russia) allows to estimate cBP over 24 h. However to date, it is unknown if 24 h monitoring of cBP have added value to office cBP measurements.

Design and method:

We looked at the average day and night pulse pressure amplification (PPamp = peripheral pulse pressure/ central pulse pressure), cBP and pulse wave velocity (PWV) in 120 (60 M/60F) normotensives (NT), 120 (60 M/60F) hypertensive dippers (DI) and 120 (60 M/60F) hypertensive non-dippers (ND) matched for age, sex and day brachial SBP for the hypertensive subjects.

Results:

Between day and night, peripheral systolic blood pressure fell from 122 ± 8 to 103 ± 7 mmHg in NT, from 140 ± 11 to 117 ± 11 mmHg in DI and from 140 ± 12 to 137 ± 14 mmHg in ND. Heart rate fell from 70 ± 8 to 59 ± 7 bpm, 77 ± 10 to 63 ± 8 bpm and from 73 ± 12 to 65 ± 11 bpm in NT, DI and ND respectively. DI patients tended to have higher day PPamp value than other groups (132 ± 7%, 135 ± 8%, 131 ± 9% in NT, DI and ND respectively, p < 0.001 ANOVA). Night PPamp was similar in each group and lower than day PPamp (123 ± 7%, 124 ± 6% and 123 ± 7%, p = 0,11). However PPamp was correlated with heart rate (R2 = 0,36, p < 0.001). After adjustement for heart rate changes, PPamp did not differ during day and night in the 3 groups.

Conclusions:

After heart rate correction, cBP seems to vary in parallel to peripheral blood pressure during the day in normotensive, dipper hypertensive and non-dipper hypertensive.

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