P1.8 ANTIHYPERTENSIVE MEDICINES OF UP TO 4-DRUG COMBINATIONS IN A LARGE, COMMUNITY-BASED STUDY: DIFFERENTIAL RELATIONSHIPS WITH BRACHIAL BLOOD PRESSURE AND AORTIC WAVEFORM PARAMETERS

J. Sluyter; A. Hughes; A. Lowe; K. Parker; B. Hametner; S. Wassertheurer; R. Scragg

doi:10.1016/j.artres.2014.09.089

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Volume 8, Issue 4, December 2014, Pages 131 - 131

P1.8 ANTIHYPERTENSIVE MEDICINES OF UP TO 4-DRUG COMBINATIONS IN A LARGE, COMMUNITY-BASED STUDY: DIFFERENTIAL RELATIONSHIPS WITH BRACHIAL BLOOD PRESSURE AND AORTIC WAVEFORM PARAMETERS

Authors

J. Sluyter^a, A. Hughes^b, A. Lowe^c, K. Parker^d, B. Hametner^e, S. Wassertheurer^e, R. Scragg^a

^aUniversity of Auckland, Auckland, New Zealand

^bUniversity College London, London, UK

^cAuckland University of Technology, Auckland, New Zealand

^dImperial College London, London, UK

^eAustrian Institute of Technology, Vienna, Austria

Available Online 4 November 2014.

DOI: 10.1016/j.artres.2014.09.089 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Background: Comparing relationships that antihypertensives have with brachial blood pressure (BP) and aortic waveform parameters helps clinicians to predict the effect on the latter in brachial BP-based antihypertensive therapy. We aimed to make such comparisons with new waveform measures and a wider range of antihypertensive regimens than examined in previous research.

Methods: Cross-sectional analysis of 2915 adults (61% male; aged 50–84 years): 1619 on antihypertensive treatment and 1296 untreated hypertensives. Sixteen medicine regimens of up to 4 combinations of drugs from six antihypertensive classes were analysed. Aortic systolic BP (SBP), augmentation index (AIx), excess pressure integral, reflection index (RI), backward pressure amplitude (Pb) and pulse wave velocity (PWV) were calculated from aortic pressure waveforms derived from suprasystolic brachial measurement.

Results: For all regimens, brachial SBP was lower with antihypertensive use. However, while brachial SBP did not differ across the 16 regimens (P=0.17), RI (P<0.0001), Pb (P=0.0001) and AIx (P<0.0001) did. This was predominantly due to beta-blocker associations: forest plots of single-drug class comparisons across regimens with the same number of drugs (for between 1- and 3-drug regimens) revealed that AIx, Pb and RI were higher with the use of a beta-blocker compared with vasodilators and diuretics, despite no differences in brachial SBP. Compared to those untreated, beta-blocker use was associated with greater percentage differences in brachial BP than aortic waveform parameters.

Conclusions: Beta-blocker use has weaker associations with wave reflection measures than brachial SBP, suggesting that effects on these may be overestimated with brachial BP-based antihypertensive therapy.

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Journal: Artery Research
Volume-Issue: 8 - 4
Pages: 131 - 131
Publication Date: 2014/11/04
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2014.09.089 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Cite this article

ris enw bib

TY  - JOUR
AU  - J. Sluyter
AU  - A. Hughes
AU  - A. Lowe
AU  - K. Parker
AU  - B. Hametner
AU  - S. Wassertheurer
AU  - R. Scragg
PY  - 2014
DA  - 2014/11/04
TI  - P1.8 ANTIHYPERTENSIVE MEDICINES OF UP TO 4-DRUG COMBINATIONS IN A LARGE, COMMUNITY-BASED STUDY: DIFFERENTIAL RELATIONSHIPS WITH BRACHIAL BLOOD PRESSURE AND AORTIC WAVEFORM PARAMETERS
JO  - Artery Research
SP  - 131
EP  - 131
VL  - 8
IS  - 4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2014.09.089
DO  - 10.1016/j.artres.2014.09.089
ID  - Sluyter2014
ER  -

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