Key result
Hypertensive patients with normalized 24-hour blood pressure on ≥3 medications had significantly higher pulse wave velocity than normotensive controls (11.7 vs 8.3 m/s; P<.001).
Why the study?
Does intensive antihypertensive therapy normalize pulsatile hemodynamics in hypertensive patients with normalized 24-hour ambulatory blood pressure compared to normotensive controls?
Case-Control (n=114)
Does intensive antihypertensive therapy normalize pulsatile hemodynamics in hypertensive patients with normalized 24-hour ambulatory blood pressure compared to normotensive controls?
Even when 24-hour ambulatory blood pressure is normalized by intensive medical therapy, hypertensive patients retain significant residual arterial stiffness and abnormal wave reflection.
Answers are grounded in this paper and cite their sources.
Residual stiffness persists despite normalized ambulatory BP on ≥3 agents; leaves open whether PWV-guided adjunctive therapy improves outcomes.
It remains uncertain whether intensive antihypertensive therapy can normalize pulsatile hemodynamics resulting in minimized residual cardiovascular risks. In this study, office and 24-hour ambulatory systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, carotid-femoral pulse wave velocity (PWV), and forward (Pf) and reflected (Pb) pressure wave from a decomposed carotid pressure wave were measured in hypertensive participants. Among them, 57 patients whose 24-hour SBP and DBP were normalized by three or more classes of antihypertensive medications were included. Another 57 age- and sex-matched normotensive participants were randomly selected from a community survey. The well-treated hypertensive patients had similar 24-hour SBP, lower DBP, and higher PP values. The treated patients had higher PWV (11.7±0.3 vs 8.3±0.2 m/s, P<.001), Pf, Pb, Pb/Pf, and left ventricular mass index values. After adjustment for age, sex, body mass index, and office SBP, the differences for PWV, Pb, and Pb/Pf remained significant. Hypertensive patients whose 24-hour SBP and DBP are normalized may still have markedly increased arterial stiffness and wave reflection.
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Lu et al. (2015) conducted a case-control in Hypertension (n=114). Treated hypertension with normalized 24-hour BP on ≥3 medications vs. Normotensive controls was evaluated on Carotid-femoral pulse wave velocity (PWV) (p=<.001). Hypertensive patients with normalized 24-hour blood pressure on ≥3 medications had significantly higher pulse wave velocity than normotensive controls (11.7 vs 8.3 m/s; P<.001).
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