[PP.08.07] THE IMPORTANCE OF HEMODINAMIC PROFILE IN THE MANAGEMENT OF HYPERTENSIVE PATIENTS. (September 2016)

• Record Type: Journal Article
• Authors: Tautu, O.; Ghiurco, I.; Dorobantu, M.
• Is Part Of: Journal of hypertension. Volume 34:(2016) Supplement 2
• Publication Date: 2016-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000491779.15295.6f
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: To analyze the hemodynamic profile of treated hypertensive patients without optimal blood pressure control and to evaluate the consequences of an anti-hypertensive treatment that do not properly address the hemodynamic profile of these patients. Design and method: Fifty-one consecutive hypertensive patients treated with at least 2 anti-hypertensive drugs admitted to our department between February 2014-May 2015 for uncontrolled blood pressure (BP) (over 140/90mmHg) and who gave written consent to participate in the study were evaluated by 12 lead ECG (for LVH by Socolow-Lion criterion), standard trans-thoracic echocardiography by GE Vivid 7 (LVEF, transmitral Doppler Flow pattern, LA enlargement and LVH) and non-invasive hemodynamic evaluation by HOTMAN system (volemia, ionotropism, vasoactivity and chronotropism). Results: Study sample had a mean age of 61.39 ± 13.3 years (range 32–89 years) with an equal gender distribution (30 males; 58.8% and 21 females; 41.2%). Mean values of BP and hemodynamic parameters were: SBP 152.59 ± 19.522 mmHg; DBP 88.27 ± 11.93 mmHg; MAP: 109.67 ± 12.930 mmHg; SI: 49.18 ± 20.73 ml/beat/m2; LSWI: 72.44 ± 31.88 g x m/m2; SSVRI: 208.37 ± 106.59 dyn x sec x cm -5 x m2. There were 6 different hemodynamic profiles (Figure 1) and 10 different patterns of altered hemodynamic modulators (Figure 2). Only one patient out of 51 was receiving appropriate anti hypertensive drug class according to its hemodynamic modulators. In their majority (70.6%) patients from the study sample were receiving inappropriate anti hypertensive drugs according to theirs hemodynamic modulators that negatively influenced at least 2 hemodynamic modulators. There was a direct positive association between the number of altered hemodynamic modulators during anti hypertensive drug treatment and an increased frequency of LVH and LV diastolic dysfunction (Figure 3). Figure. No caption available. Conclusions: Uncontrolled treated hypertensive patients have a wide variety of hemodynamic profiles with at least 2 altered hemodynamic modulators requiring therefore an individualized therapeutic approach. Failure to address altered hemodynamic modulators by proper anti-hypertensive drug class results in more frequent sub-clinical target organ damage.