The Potential of the Volumetric Sphygmography for the Diagnosis of Impaired Arterial Stiffness in Patients with Uncomplicated Arterial Hypertension and Its Possibilities for Evaluation of the Antihypertensive Therapy Effectiveness

Aim . To investigate arterial stiffness parameters in middle-aged patients with stage II grade 1-2 essential arterial hypertension (HT) and evaluate their changes after treatment with single pill combinations (SPC) of antihypertensive drugs. Methods . At the first phase of the study, according to the medical records data, a group of untreated patients with stage II grade 1-2 HT (n=100, 47 men, mean age 51.9±6.5 years), and a group of healthy controls with normal blood pressure (BP) (n=86; 28 men; mean age 48.8±5.8 years) were formed. The analysis of arterial stiffness was performed by the volumetric sphygmography technique using VaSera VS-1500N device (Fukuda Denshi Co., Ltd, Japan). All the subjects underwent ambulatory BP monitoring (BPLab, BP2005-01.04.00.2540, Petr Telegin, Russia) as well as a routine BP measurement by the Korotkov method. At the second stage of the study, a group of HT patients (n=90) was formed according to the medical history data. These patients thanks to antihypertensive treatment with SPC (perindopril arginine/indapamide or valsartan/amlodipine) achieved the target BP level (<140/90 mm Hg) according to routine measurements and they were assessed in terms of therapy efficacy (general clinical data, SMAD, volume sphygmography) 12 weeks after the target BP level was reached. Results . At the first phase of the study, in HT patients cardio-ankle vascular index (CAVI), both on the left (7.9±1.3) and right side (8.1±1.3), as well as the right-side augmentation index (1.22±0.31%) were significantly higher (p=0.006, p=0.003, p=0.047, respectively) compared to the controls (7.5±0.9, 7.6±0.9, 1.13±0.28%, respectively). At the second phase of the study, after SPC treatment the CAVI significantly decreased both on the left- (up to 7.36±1.37, p=0.02) and right-side (up to 7.46±1.44, p=0.02). Conclusions . In untreated 40-65 years-old patients with stage II grade 1-2 HT arterial stiffness assessed by volumetric sphygmography is significantly higher compared with sex-matched healthy individuals. 12-week therapy with SPCs improves the elastic properties of the major arteries, reducing the CAVI value.