PP.22.04: THE RELATIONSHIP AMONG HEMODYNAMIC MODULATORS, TREATMENT AND ECHOCARDIOGRAPHIC PARAMETERS IN UNCONTROLLED HYPERTENSIVE PATIENTS. (June 2015)

• Record Type: Journal Article
• Authors: Ghiurco, I.; Deaconu, A.; Tautu, O.; Iancovici, S.; Dorobantu, M.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000468393.01304.63
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Nowadays, about 10–15% percent of patients suffering from arterial hypertension have uncontrolled values, despite treatment. It is necessary to improve the choice of antihypertensive therapy and by determining a patient's hemodynamic profile: hemodynamic status (systolic index and mean blood pressure) and hemodynamic modulators (chronotropism, inotropism, volemia and vasoactivity) it may be possible to prescribe a personalized therapy for each patient. Design and method: We selected a group of 33 patients with uncontrolled hypertension, admitted to the Emergency Hospital of Bucharest. We define uncontrolled hypertension by values greater than 140/90 mmHg, despite treatment with two antihypertensive agents. Patients had their Mean Blood Pressure determined by ambulatory monitoring blood pressure (AMBP) in order to be included in the study. These patients were monitored using HOTMAN® thoracic electrical bioimpedance system to determine their hemodynamic profile. ECG and echocardiography were performed. Results: Of the total number of patients, the division by gender was: 48.48% males and 51.51% women, with an average age of 62.12 years old. Comparing the most severely affected hemodynamic modulator with medication received by the patient, it was observed that 27.27% of patients were not receiving appropriate treatment. Among patients with a targeted therapy, 37.50% were taking a low dose, 45.83% medium dose, and 16.66% high dose. Echocardiographically, 84.62% of patients had impaired diastolic function, as follows: 57.69% had impaired relaxation, 19.23% pseudonormal and 7.69% filling restrictive filling pattern. Diastolic function patterns were compared to modified hemodynamic modulators. Also, left ventricular hypertrophy was present in 65.38% of patients. Conclusions: Due to the increased number of patients who had no targeted antihypertensive therapy or were prescribed a low dose (over 50%), we can conclude that hemodynamic monitoring in hypertensive patients may contribute to the choice of appropriate therapy.