Clinical value of complex ambulatory monitoring of blood pressure and arterial rigidity in elderly patients

Aim. To study the clinical and diagnostic role of pulse wave time (PWT) in 24-hour blood pressure monitoring (BPM) and its link to elasticity of larger arteries and aorta (carotid-femoral pulse wave velocity, PWVcf; cardioankle vascular index, CAVI) in patients aged over 75 years.

Material and methods. The study included 52 patients (20 men) aged over 75 years (mean age 79,1±3,5 years) with arterial hypertension (AH). Fifteen participants had cardiovascular events (CVE) in anamnesis: myocardial infarction, MI (n=11) or stroke (n=4). Sixteen patients had Functional Class II-III angina (n=16), and 32 received antihypertensive therapy. 24-hour BMP and PWT parameters were measured. Corrected PWT100-60 was calculated for systolic BP (SBP) 100 mm Hg and heart rate (HR) 60 bpm. PWVcf and CAVI were assessed with a screening device VS 1000 VaSera, Fukuda Denshi, Japan.

Results. In all participants, clinical BP level was 147,5+6,9/76,5+5,1 mm Hg; 24-hour BPM BP level - 139,6+6,7/70,7+4,6 mm Hg; PWT100-60 - 161,7+6,2 ms; PWVcf - 17,3+4,6 m/s, and CAVI - 10,6+3,1. A sig­nificant negative correlation between PWT100-60 and 24-hour BPM SBP (r=-0,36, p<0,05), 24-hour BPM PBP (r=-0,43, p<0,01), PWVcf (r=-0,54, p<0,01) and CAVI (r=-0,34, p<0,05) was observed. Patients with and without CVE were comparable by age. CVE-free participants were characterised by lower frequency of antihypertensive therapy, higher levels of clinical BP (153,5+6,9/82,5+6,3 vs. 136,5+3,4/71,1+3,9 mm Hg), higher 24-hour BPM BP (144,0+6,9/73,2+5,3 vs. 132,6+4,2/69,3+3,8 mm Hg), lower PVWcf (15,8+4 vs. 18,7+4,4 m/s), lower CAVI (9,7+2,4 vs. 11,5+3,8), and higher PWT100-60 (167+5,4 vs. 156,2+6,9 ms; p<0,05).

Conclusion. In AH patients aged over 75 years, PWT100-60 correlated with traditional indices of arterial rigidity. Lower PWT100-60 and higher PWV were observed among individuals with CVE in anamnesis.

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