[PP.28.08] LONG- AND SHORT-TERM BLOOD PRESSURE VARIABILITIES IN PATIENTS WITH CONTROLLED ARTERIAL HYPERTENSION ARE NOT INTERCHANGEABLE

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Abstract

Objective:

Visit-to-visit blood pressure variability (BPV) is associated with cardiovascular disease risk. In view of the inconvenience of obtaining blood pressure at multiple visits to calculate visit-to-visit BPV, substituting BP variability from calculating short-term variability (intravisit and 24-hours) may be a practical alternative. The aim of the study was to evaluate the associations between long-term (visit-to-visit) and short-term (intravisit and 24-hours) BPV in patients with uncomplicated controlled arterial hypertension (AH).

Design and method:

52 pts (20 men, age 58,9 ± 9,0 yrs; 4 smokers; 6 diabetics) with AH without HF were treated to target BP<140/90 mmHg with combination of RAAS-inhibitor and amlodipine for 14mo. Visit-to-visit BPV was calculated as SD for 5 visits during 8 months after target BP achievement. Intravisit BPV was calculated as SD of 3 BP values at each visit. ABPM was performed before treatment and at the end of the study.p < 0,05 was considered significant.

Results:

Baseline BP was 163,4 ± 8,1/100,9 ± 4,2 mmHg; achieved-123,7 ± 9,7/76,8 ± 6,7 mmHg. Intravisit SBPV varied from 0,8 to 7,0 mmHg (mean 3,1 ± 1,1 mmHg), DBPV – from 0,8 to 4,2 mmHg (mean 2,3 ± 0,7 mmHg). Daytime SBPV varied from 6 to 29 mmHg, daytime DBPV varied from 5 to 31 mmHg. Nighttime SBPV varied from 5 to 18 mmHg, nighttime DBPV – from 4 to 23 mmHg. Visit-to-visit SBPV after achievement of target BP varied from 1,79 mmHg to 16,79 mmHg (mean 7,2 ± 3,6 mmHg); (tertile I < 5,38;II 5,38 - 7,78;III > 7,78 mmHg). The groups were similar by age (I 56,6 ± 8,94, II 59,4 ± 9, III 60,7 ± 9,1 yrs, p > 0,05), gender, metabolic risk factors, baseline and achieved BP. Groups were also similar by intravisit SBPV (3,0 ± 1,0 vs 3,4 ± 1,2 vs 3,0 ± 1,2 mmHg, respectively), intravisit DBPV (2,1 ± 0,8 vs 2,1 ± 0,4 vs 2,5 ± 0,9 mmHg, respectively); daytime SBPV (13,5 ± 3,8 vs 15,6 ± 2,9 vs 14,9 ± 5,1 mmHg), daytime DBPV (14,0 ± 6,1 vs 13,6 ± 3,3 vs 12,3 ± 4,7 mmHg), nighttime SBPV (10,7 ± 2,9 vs 11,6 ± 3,1 vs 11,4 ± 3,1 mmHg) and nighttime DBPV (8,2 ± 2,5 vs 10,2 ± 3,5vs 9,9 ± 4,0 mmHg). No correlation was found between visit-to-visit BPV and short-term variability.

Conclusions:

Absence of association between visit-to-visit blood pressure variability and short-term variability underlines the importance of its separate calculation in patients with uncomplicated controlled AH without HF.

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