Blood Pressure

Amplification of SBP, Pulse Pressure Is Higher in Patients With Resistant Hypertension, Regardless of BP Control

Measuring central blood pressure (BP) among patients with resistant hypertension (RHTN) may better predict cardiovascular disease (CVD) morbidity and mortality, according to new research presented at the American Heart Association’s Hypertension 2019 Scientific Sessions.1

The research team set out to investigate whether BP amplification was different among patients with uncontrolled resistant hypertension (uRHTN) than in those with controlled resistant hypertension (cRHTN) and controlled non-resistant hypertension (cnRHTN).

“We found that higher differences in blood pressure between the arm and the aorta are associated with increased incidence of heart disease in the general population,” said Badhma Valaiyapathi, MBBS, MPH, lead study author and a postdoctoral fellow in vascular biology at the hypertension clinic at the University of Alabama at Birmingham. “We looked specifically at people whose high blood pressure is resistant to treatment, meaning patients’ arm blood pressure readings remain out of control despite the patient being on high blood pressure medications.”2

To conduct their study, the researchers recruited 149 patients from the University of Birmingham’s Hypertension Clinic. Brachial BP, aortic BP, and BP amplification were measured in each patient.

Results of the multiple regression analysis showed a significant correlation between gender and increasing body mass index, with amplification of systolic BP and pulse pressure.

Amplification of systolic BP and pulse pressure were significantly higher among participants with uRHTN than in participants with cRHTN. In addition, participants with cRHTN had higher amplification than those with cnRHTN.

“This prospective study showed that the amplification of [systolic BP] and [pulse pressure] remains high in patients with RHTN regardless of BP control, indicating that patients with RHTN retain a higher risk of CVD morbidity and mortality in spite of successful BP control,” the researchers concluded.1

—Amanda Balbi

References:

  1. Valaiyapathi B, Dudenbostel T, Siddiqui M, Zhang B, El Hachem M, Oparil S, Calhoun DA. Abstract 104: Amplification of systolic blood pressure and pulse pressure is higher in resistant hypertensive patients irrespective of blood pressure control [published online September 4, 2019]. Hypertension. https://doi.org/10.1161/hyp.74.suppl_104.
  2. Arm cuff blood pressure measurements may fall short for predicting heart disease risk in some people with resistant high blood pressure [press release]. New Orleans, LA: American Heart Association; September 5, 2019. https://newsroom.heart.org/news/arm-cuff-blood-pressure-measurements-may-fall-short-for-predicting-heart-disease-risk-in-some-people-with-resistant-high-blood-pressure.