MODULATING EFFECT OF TARGET BLOOD PRESSURE ACHIEVEMENT ON PULSE WAVE VELOCITY IN HYPERTENSIVE PATIENTS

Objective. Carotid-femoral pulse wave velocity (PWV) is a strong independent predictor of cardiovascular morbidity and mortality. The aim of the study was to evaluate treatment-induced changes in PWV in hypertensive subjects achieved target clinic blood pressure (BP). Design and methods. Patients with grade I–II hypertension were treated to achieve target clinic BP < 140/90 mmHg with combination of RAAS-inhibitors and amlodipine for 1 year. Baseline BP was 163,4 ± 8,1/100,9 ± 4,2 mmHg; achieved BP 123,7 ± 9,7/76,8 ± 6,7mmHg. Central BP and PWV were measured before treatment and after 8 months of target clinic BP was maintained. Results. In 47 patients (20 men, age 58,9 ± 9,0 years) target clinic BP was achieved and maintained for 8 months. In 11 (23 %) subjects PWV decreased by ≥ 1 m/s from baseline (G1), in 15 (32 %) patients it remained unchanged (G2), and in 21 (45 %) it increased by ≥ 1 m/s compared to baseline (G3). The groups were comparable by age, risk factors, baseline and achieved clinic BP. PWV differed between the groups at baseline (G1 15,9 ± 2,5 vs. G2 13,6 ± 1,9 vs. G3 10,9 ± 1,7 m/s, р < 0,05), but not at the end of the study (13,0 ± 2,1; 13,6 ± 1,9 and 13,4 ± 1,9 m/s, respectively, p > 0,05). Also 72,7 % of patients in G1 and 66,7 % in G2 received the highest recommended doses of RAAS-inhibitors and amlodipine 10 mg vs. 28,6 % in G3 (Pearson χ 2 = 9,0; р < 0,05). Correlation and multiple regression analysis revealed the association between PWV decrease and doses of RAAS-inhibitors and amlodipine (r = –0,5, β = –0,45, p < 0,05). Conclusions. There is a modulating effect of target BP achievement on PWV in hypertensive subjects. PWV reduction is associated with higher doses of RAAS inhibitors and amlodipine.

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