Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Robson Pierre Pacífico Alves Filho¹  Weimar Kunz Sebba Barroso¹  Adriana Sebba Barroso¹  Paulo César Brandão Veiga Jardim¹  Ana Luiza Lima Sousa¹  Gilberto Campos Guimarães Filho¹  Sayuri Inuzuka¹  Victoria Alves Melo¹  Luiz Fernando de Oliveira Urzeda¹  Antonio Coca²  Priscila Valverde de Oliveira Vitorino³ 

[1] Hypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, Brazil;Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, Spain;School of Social Science and Health, Pontifical Catholic University of Goiás, Goiânia, Brazil;

关键词: arterial stiffness;    central blood pressure;    clinical trial;    hypertension;    pulse wave velocity;   

DOI  :  10.3389/fcvm.2023.1247146

 received in 2023-06-25, accepted in 2023-08-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundArterial hypertension treatment guided by central blood pressures (CPB) rather than peripheral blood pressures (PBP) measurement has the potential to show greater effectiveness in preventing or even regressing stiffness and target organ damage (TOD).ObjectiveThis study aimed to compare the parameters of CBP and PBP measurements, arterial stiffness, TOD and renal profile in patients with anti-hypertensive treatment guided by CBP or PBP targets.MethodsA randomized clinical trial was conducted in central group (CG) and peripheral group (PG). Patients were randomized, evaluated every 3 months for BP and antihypertensive adjustments during a one-year follow up. The procedures in V1 and V5: anthropometric assessment; CBP/PBP measurements, carotid ultrasound; echocardiography; laboratory tests. Paired and unpaired t-tests and the χ2 were used (significance level: 5%).ResultsThe study evaluated 59 participants (30CG/29PG). The augmentation index (AIx) was higher in the CG (27.3% vs. 20.3%, p = 0.041). Intergroup analysis has found central diastolic BP lower in the CG (78.9 vs. 84.3 mmHg, p = 0.024) and the Alx difference between groups ceased to exist after a one-year follow-up. Intragroup comparisons, after intervention, showed a lower frequency of changed PWV (p < 0.001) and LVMI (p = 0.018) in the CG. The PG showed a higher frequency of changed PWV (p < 0.001) and LVMI (p = 0.003).ConclusionThe intervention guided by central BP reduced the central diastolic BP and AIx compared to the PG. There was a reduction in the frequency of changed PWV and LVMI in the CG.

【 授权许可】

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© 2023 Guimarães Filho, de Oliveira Vitorino, Inuzuka, Barroso, Pacífico Alves Filho, Melo, de Oliveira Urzeda, Lima Sousa, Coca, Veiga Jardim and Barroso.