SYSTOLIC BLOOD PRESSURE PHENOTYPING BASED ON BOTH AORTIC AND BRACHIAL MEASUREMENTS AND ITS RELATIONSHIP WITH INTERMEDIATE HYPERTENSION PHENOTYPES AND ARTERIAL STIFFNESS. (June 2018)

• Record Type: Journal Article
• Authors: Koletsos, N.; Gkaliagkousi, E.; Triantafyllou, A.; Lazaridis, A.; Zafeiridis, A.S.; Anyfanti, P.; Dipla, K.; Douma, S.
• Is Part Of: Journal of hypertension. Volume 36(2018)Supplement 1
• Publication Date: 2018-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000539494.34330.16
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: High aortic systolic blood pressure (aSBP) is stronger associated with target organ damage as compared to brachial systolic BP (bSBP). Office SBP phenotypes based on both brachial and aortic measurements have been recently proposed as a new classification system that could improve cardiovascular risk stratification and reveal subgroups of higher or lower risk of vascular damage. We sought to investigate: A) whether the above phenotyping could help to identify all hypertension phenotypes [True (TH), white-coat (WCH) and masked hypertensives (MH)] without applying ambulatory BP monitoring (ABPM), a gold standard method in the diagnosis of hypertension, however not always available in everyday clinical practice, and B) if the above combination of aSBP and bSBP is more sensitive to detect subgroups with increased arterial stiffness and thereby increased cardiovascular risk. Design and method: Based on their office bSBP and aSBP values, participants were classified into four office SBP phenotypes, using both the sex-adjusted 90th percentile and the rounded threshold of 130mmHg: type I was defined as both normal bSBP and aSBP, type II high bSBP with normal aSBP, type III normal bSBP but high aSBP and type IV both high bSBP and aSBP. Moreover, all participants underwent ABPM and were further classified into normotensives (NT), WCH, MH and TH. Arterial stiffness was assessed via pulse wave velocity (PWV). Results: The study included 391 untreated individuals (58.1% male) with a mean age of 44.0 ± 12.6 years (138 NT, 21 WCH, 52 MH and 180TH).No differences were observed in age, body mass index and smoking status. Most TH (68.9–87.8%) were type IV, while > 90% of normotensives were classified as type I. The majority of WCH (47.6–71.4%) were type IV, while < 45% of the MH had high aSBP and were type III. PWV was significantly lower between type I and all other types, as well as between III and IV type (p < 0.001). Conclusions: Our results showed that high aSBP deteriorates arterial stiffness regardless of the levels of bSBP. Therefore although SBP phenotyping doesn't help to identify WCH or MH, its use in the everyday clinical practice can improve cardiovascular risk stratification.