Predictors of insufficient response to initial antihypertensive treatment

To compare baseline central pulse wave characteristics in relation to response to initial antihypertensive treatment in previously untreated hypertensive patients. Design and methods. The study included 57 subjects (mean age 50,2 ± 13,7 years) with untreated arterial hypertension grade 1-2 without target organ damage on routine examination. Antihypertensive therapy was initiated after baseline ambulatory blood pressure monitoring (ABPM) and pulse wave analysis. Response to treatment was classified by joint evaluation of ABPM and clinic BP after 8 weeks of treatment. The baseline pulse wave velocity (PWV) was compared in 4 groups: 1) true responders (TR, normal clinic and ambulatory BP), 2) masked responders (MR, elevated clinic and normal ambulatory BP), 3) masked non-responders (MNR, normal clinic and elevated ambulatory BP), 4) true non-responders (TNR, elevated clinic and elevated ambulatory BP). Results. There were 21 (36,8 %) TR, 11 (19,3 %) MR, 11 (19,3 %) MNR, 14 (24,6 %) TNR. MNR was the youngest group but their baseline central systolic, pulse BP and PWV were at least similar or even higher than in the other groups. Conclusion. The results suggest that increased arterial stiffness may be responsible for insufficient response to initial antihypertensive treatment in non-diabetic hypertensive patients.

arterial hypertension, masked hypertension, arterial stiffness, pulse wave velocity

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