Objective: To test K.Kario hypothesis (J Am S Hypertens 2010; 4(5):215–218) that predominant “arterial stiffness” (AS) and “volume-dependent” (V) types of arterial hypertension may exist and thus evaluation of arterial stiffness and volume-dependency status may help to choice between a calcium channel blocker (as “anti-stiffness” drug) and a diuretic (as “anti-volume” drug) to achieve blood pressure (BP) control.

Methods: Pulse wave velocity (PWV, SphygmoCor, AtCor, Australia) and plasma renin activity (PRA, radioimmune assay) were measured in 124 (48 men) untreated hypertensive patients aged 50–65 years (mean 59,6±5,1 years) with GFR CKD-EPI >60 ml/min/1,73 m2. AS-typing was done by individual PWV interpretation (Boutouyrie P., Vermeersch S.J. Eur Heart J 2010;31:2338–350). PRA <0,65 ng/ml/h was considered as V-type, PRA >0,65 ng/ml/h - as renin (R) type.

Results: V-type was found in 57,3%, R-type in 42,7%, AS-type in 47,6% patients. Isolated (normal PWV) types were observed in 52,4%, isolated R-type was more prevalent (38,7%) than isolated V-type (13,7%). AS+V-type was found in 43,6%, AS+R-type - in 4,0%. It means that 76,1% of patients with V-type had elevated PWV and 91,5% of patients with increased AS are volume-dependent. Multifactor analysis failed to reveal independent predictors of isolated or mixed types, but independent correlation between PRA and PWV (β=−0,45, p<0,001) and pulse pressure amplification (β=0,76, p<0,001) was found.

Conclusion: Significant over-lap in “arterial stiffness” and “volume” types of arterial hypertension agues against possibility of differential choice between a calcium channel blocker and a diuretic for BP lowering guided by evaluation of PWV and PRA