[Pressure wave reflections and central blood pressure in treated hypertensive subjects].

ABSTRACT

OBJECTIVE: To investigate the differences in pressure wave reflections and central blood pressure between brachial BP classification and the effect of antihypertensive drugs. METHOD: In 1371 chronically treated hypertensive subjects aged 33 - 87 years [679 males and 692 females, mean age (47.2 ± 11.5) years], radial arterial augmentation index (rAI) and central systolic blood pressure were measured using an automated tonometric method. RESULTS: rAI gradually increased from the subgroup with the lower blood pressure to the higher blood pressure (P < 0.01), for each given brachial value, central systolic blood pressure was lower than the corresponding brachial pressure (P < 0.01). In multivariable linear regression models analysis revealed that the application of angiotensin converting enzyme inhibitor (ß = -0.09, P < 0.05), AT1 receptor blockade (ß = -0.07, P = 0.01), calcium channel blocker (ß = -0.12, P < 0.01) and diuretic (ß = 0.14, P = 0.04) were independent determinants of rAI. Central SBP significantly correlated to the application of ACEI (ß = -0.07, P = 0.02), ARB (ß = -0.08, P = 0.01) and CCB (ß = -0.15, P < 0.05). CONCLUSIONS: In chronically treated hypertensive individuals, tight blood pressure control would be effective in reducing the reflection wave and central BP. Antihypertensive treatment strategies with more beneficial effects on arterial properties are needed.