For some patients, central blood pressure measurements in difficult-to-treat hypertensive patients may be more helpful in reducing the risk of heart disease than traditional cuff readings.
Central blood pressure, also known as blood pressure amplification, is measured at the aorta of the artery closest to the heart. The researchers found that, based on their findings, this measurement could more accurately reflect the risk of heart disease in treating patients with resistant hypertension.
“We found that the difference in blood pressure between the arm and the aorta is associated with an increased incidence of heart disease in the general population,” said Badhma Valaiyapathi, MBBS, MPH, lead study author and postdoctoral fellow in hypertension vascular biology. University of Alabama Birmingham Clinic. “We pay special attention to those who have high blood pressure and are resistant to treatment, which means that patients’ blood pressure readings in their arms are still out of control, despite patients taking hypertension medications.”
The researchers studied adult patients with hypertension, including some patients with hypertension that are difficult to treat. Blood pressure and pulse pressure are measured using traditional arm cuffs and pulse wave analysis to measure central blood pressure when the heart pumps blood. Based on the measurements, patients were divided into three groups: controlled non-tolerant blood pressure; controlled resistance blood pressure; and uncontrolled resistance blood pressure. Calculate blood pressure magnification as the difference between the two measurements.
Most hypertensive amplification was found in patients with uncontrolled drug-resistant hypertension. Valaiyapathi said that blood pressure rose the least among those who controlled the non-resistance category, which explains why the risk severity is highest in some adults with uncontrolled hypertension and resistance to certain drugs.
“Research results show that blood pressure and pulse pressure remain high in patients with refractory hypertension, regardless of blood pressure control,” he said. “This means their arteries are stiffer than patients with blood pressure control, and problems with their blood vessels cause heart disease, even if they take medication, even if their blood pressure is controlled.”
Valaiyapathi suggests that doctors should tailor blood pressure treatments for patients with resistant hypertension by considering central blood pressure, amplifying and strengthening the importance of lifestyle changes to patients-not just drugs-to reduce the risk of heart disease.
One of the limitations of the study is that it is small and conducted in the southern United States, so results may not be reproducible in the general U.S. population.
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Post time: Jan-10-2020