Hemodynamic profiles of arterial hypertension with ambulatory blood pressure monitoring

ABSTRACT: Blood pressure (BP) measurements obtained during a twenty-four-hour ambulatory blood pressure monitoring (24 h ABPM) have not been reliably applied to extract arterial hemodynamics. We aimed to describe the hemodynamic profiles of different hypertension (HT) subtypes derived from a new method for total arterial compliance (Ct) estimation in a large group of individuals undergoing 24 h ABPM. A cross-sectional study was conducted, which included patients with suspected HT. Cardiac output, Ct, and total peripheral resistance (TPR) were derived through a two-element Windkessel model without having a pressure waveform. Arterial hemodynamics were analyzed according to HT subtypes in 7434 individuals (5523 untreated HT and 1950 normotensive controls [N]). The individuals mean age was 46.2 ± 13.0 years; 54.8% were male, and 22.1% were obese. In isolated diastolic hypertension (IDH), the cardiac index (CI) was greater than that in normotensive (N) controls (CI: IDH vs. N mean difference 0.10 L/m/m2; CI 95% 0.08 to 0.12; p value <0.001), with no significant clinical difference in Ct. Isolated systolic hypertension (ISH) and divergent systolic-diastolic hypertension (D-SDH) had lower Ct values than nondivergent HT subtype (Ct: divergent vs. nondivergent mean difference −0.20 mL/mmHg; CI 95% −0.21 to −0.19 mL/mmHg; p value <0.001). Additionally, D-SDH displayed the highest TPR (TPR: D-SDH vs. N mean difference 169.8 dyn*s/cm−5; CI 95% 149.3 to 190.3 dyn*s/cm−5; p value <0.001). A new method is provided for the simultaneous assessment of arterial hemodynamics with 24 h ABPM as a single diagnostic tool, which allows a comprehensive assessment of arterial function for hypertension subtypes.

• Autores: Gallo Villegas, Jaime Alberto; Aristizábal Ocampo, Dagnovar; Álvarez Montoya, Diego Luis; Madrid Muñoz, Camilo Alberto; Fallon Giraldo, Simon
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2023
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/33868
• Acceso en línea: https://hdl.handle.net/10495/33868
• Palabra clave: Monitoreo Ambulatorio de la Presión Arterial; Blood Pressure Monitoring, Ambulatory; Hemodinámica; Hemodynamics; Hipertensión; Hypertension; Resistencia Vascular; Vascular Resistance; Estudios Transversales; Cross-Sectional Studies
• Rights: openAccess
• License: http://creativecommons.org/licenses/by/2.5/co/