Open AccessAbnormal Pulsatile Hemodynamics in Hypertensive Patients With Normalized 24‐Hour Ambulatory Blood Pressure by Combination Therapy of Three or More Antihypertensive Agents
Author(s) -
Lu DaiYin,
You LiKai,
Sung ShihHsien,
Cheng HaoMin,
Lin ShingJong,
Chiang FuTien,
Chen ChenHuan,
Yu WenChung
Publication year - 2016
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12751
Subject(s) - medicine , pulse wave velocity , blood pressure , pulsatile flow , cardiology , ambulatory blood pressure , arterial stiffness , pulse pressure , ambulatory , hemodynamics , diastole , body mass index
It remains uncertain whether intensive antihypertensive therapy can normalize pulsatile hemodynamics resulting in minimized residual cardiovascular risks. In this study, office and 24‐hour ambulatory systolic blood pressure ( SBP ), diastolic blood pressure ( DBP ), pulse pressure, carotid‐femoral pulse wave velocity ( PWV ), and forward (Pf) and reflected (Pb) pressure wave from a decomposed carotid pressure wave were measured in hypertensive participants. Among them, 57 patients whose 24‐hour SBP and DBP were normalized by three or more classes of antihypertensive medications were included. Another 57 age‐ and sex‐matched normotensive participants were randomly selected from a community survey. The well‐treated hypertensive patients had similar 24‐hour SBP , lower DBP , and higher PP values . The treated patients had higher PWV (11.7±0.3 vs 8.3±0.2 m/s, P <.001), Pf, Pb, Pb/Pf, and left ventricular mass index values . After adjustment for age, sex, body mass index, and office SBP , the differences for PWV , Pb, and Pb/Pf remained significant. Hypertensive patients whose 24‐hour SBP and DBP are normalized may still have markedly increased arterial stiffness and wave reflection.