Pp.06.09: the values of 24-hour augmentation index in patients with high normal blood pressure and hypertension

Objective: The 24-hour monitoring of arterial stiffness may have some potential advantages in comparison with standard methods, but its clinical value needs further investigation. The aim of the study was to assess the values of 24-hour augmentation index in patients with high normal blood pressure (BP) and hypertension and their association with 24-hour BP. Design and method: The database of the trial on the influence of the seasonal factors on BP was used. Patients from the general population who visited ambulatory clinics for various reasons were included. The main inclusion criterion was office blood pressure 130/85–159/99 mm Hg or long-term antihypertensive therapy. The ambulatory blood pressure monitoring (ABPM) was performed with the BPLab device (Nizny Novgorod, Russia) twice in each patient: in winter (December-February 2012–2014) and in summer (June-August 2012–2014). The interval between ABPMs was 6 months±7 days. The selection criterion for ABPM records was the quality adequate for sophisticated analyses: duration >24 hours, absence of data gaps >1 hour, >55 readings per 24 hours. The ABPM waveforms were analyzed by a special automatic algorithm using BPLab Vasotens technology, which allows calculation of central pulse wave parameters from the peripheral pulse wave. The data analyses were adjusted for age, sex, and patient position at each measurement. Results: 1766 patients were enrolled, and 1423 of them completed the first visit - 641 from Ivanovo (mean age 52 ± 9 years, 244 men), and 782 from Saratov (mean age 58 ± 12 years, 449 men). The data of the first visit were used in cross-sectional analyses. The values of both 24-hour brachial (AIx) and aortal (AIxao) augmentation indices were minimal in patients with high normal blood pressure (HNBP) and maximal in untreated hypertension (UH). At the same time, the minimal ambulatory BP levels were found in the treated hypertension group (TH - see table).Conclusions: 24-hour monitoring of arterial stiffness appears to be a promising diagnostic method in hypertension, which provides some additional information for risk stratification.