Central blood pressure and pulse wave velocity in patients with resistant hypertension

Background. Te measurement of brachial pressure (BP) has passed been on for ages, but the central pressure detection could only be possible with invasive techniques, until recently non-invasive and modern technology was introduced into the clinical setting. Studies described that the increase in central blood pressure (CBP) is an indicator of future cardiovascular or target organ damage. Compared with the general population, cardiorenal morbidity is much higher in patients with resistant hypertension (RH). We investigated for the frst time the value of CBP and pulse wave velocity (PWV) in a group of RH patients. Materials and Methods. Data from 80 patients with RH (resistance to 3 or more drugs, one is diuretic) without chronic kidney disease, at University hospital Merkur, Zagreb from the period of June 2017 to January 2018 were analysed. Te pulse wave velocity (PWV), mean arterial pressure (MAP), vessels age (older than biological age), pulse pressure (PP), central blood pressure (CBP), brachial pressure (BP) were evaluated using the noninvasive Agedio B900 device (Germany). Results. Te median age was 58.75 (SD15.3). 27 (35%) of patients were male (avg 53.9 y). BP and CBP were elevated in all RH patients (53 F/27M). Te difference between the median value of BP (145.9/90.52mmHg, F=146.4/89.5, M=145/92) and CBP (132.16/91.78mmHg, F=132/90, M 131/94) was statistically signifcant for systolic BP (p<0.01). Te mean value of the total measured PWV value was higher than reference for age in all RH and was 8.84 m/s. Te mean value of PP and MAP was higher than reference (60.11 and 123,87 mmHg). Te diference between sex was statistically signifcant higher for PWV in females than males (M/F= 8.1/9.2m/s, p<0.01). Te diference between MAP median concentration (M/F=125.83/123) and PP (M/F=56/62mmHg) was not statistically signifcant (p>0.01). Conclusion. Currently no gold standard technique is available to measure the CBP. Future studies should address that the cuf method could be a promising device in every day practice for this high risk population