Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies
BackgroundArterial hypertension treatment guided by central blood pressures (CPB) rather than peripheral blood pressures (PBP) measurement has the potential to show greater effectiveness in preventing or even regressing stiffness and target organ damage (TOD).ObjectiveThis study aimed to compare the...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1247146/full |
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| author | Gilberto Campos Guimarães Filho Priscila Valverde de Oliveira Vitorino Sayuri Inuzuka Adriana Sebba Barroso Robson Pierre Pacífico Alves Filho Victoria Alves Melo Luiz Fernando de Oliveira Urzeda Ana Luiza Lima Sousa Antonio Coca Paulo César Brandão Veiga Jardim Weimar Kunz Sebba Barroso |
| author_facet | Gilberto Campos Guimarães Filho Priscila Valverde de Oliveira Vitorino Sayuri Inuzuka Adriana Sebba Barroso Robson Pierre Pacífico Alves Filho Victoria Alves Melo Luiz Fernando de Oliveira Urzeda Ana Luiza Lima Sousa Antonio Coca Paulo César Brandão Veiga Jardim Weimar Kunz Sebba Barroso |
| author_sort | Gilberto Campos Guimarães Filho |
| collection | DOAJ |
| description | BackgroundArterial hypertension treatment guided by central blood pressures (CPB) rather than peripheral blood pressures (PBP) measurement has the potential to show greater effectiveness in preventing or even regressing stiffness and target organ damage (TOD).ObjectiveThis study aimed to compare the parameters of CBP and PBP measurements, arterial stiffness, TOD and renal profile in patients with anti-hypertensive treatment guided by CBP or PBP targets.MethodsA randomized clinical trial was conducted in central group (CG) and peripheral group (PG). Patients were randomized, evaluated every 3 months for BP and antihypertensive adjustments during a one-year follow up. The procedures in V1 and V5: anthropometric assessment; CBP/PBP measurements, carotid ultrasound; echocardiography; laboratory tests. Paired and unpaired t-tests and the χ2 were used (significance level: 5%).ResultsThe study evaluated 59 participants (30CG/29PG). The augmentation index (AIx) was higher in the CG (27.3% vs. 20.3%, p = 0.041). Intergroup analysis has found central diastolic BP lower in the CG (78.9 vs. 84.3 mmHg, p = 0.024) and the Alx difference between groups ceased to exist after a one-year follow-up. Intragroup comparisons, after intervention, showed a lower frequency of changed PWV (p < 0.001) and LVMI (p = 0.018) in the CG. The PG showed a higher frequency of changed PWV (p < 0.001) and LVMI (p = 0.003).ConclusionThe intervention guided by central BP reduced the central diastolic BP and AIx compared to the PG. There was a reduction in the frequency of changed PWV and LVMI in the CG. |
| first_indexed | 2024-03-12T01:11:55Z |
| format | Article |
| id | doaj.art-88f05f78f223427190992da32da77b3d |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-12T01:11:55Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-88f05f78f223427190992da32da77b3d2023-09-14T01:06:02ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-09-011010.3389/fcvm.2023.12471461247146Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategiesGilberto Campos Guimarães Filho0Priscila Valverde de Oliveira Vitorino1Sayuri Inuzuka2Adriana Sebba Barroso3Robson Pierre Pacífico Alves Filho4Victoria Alves Melo5Luiz Fernando de Oliveira Urzeda6Ana Luiza Lima Sousa7Antonio Coca8Paulo César Brandão Veiga Jardim9Weimar Kunz Sebba Barroso10Hypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilSchool of Social Science and Health, Pontifical Catholic University of Goiás, Goiânia, BrazilHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilHypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, SpainHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilHypertension League and Graduate Program, Department of Cardiology, Medicine School Federal University of Goiás, Goiânia, BrazilBackgroundArterial hypertension treatment guided by central blood pressures (CPB) rather than peripheral blood pressures (PBP) measurement has the potential to show greater effectiveness in preventing or even regressing stiffness and target organ damage (TOD).ObjectiveThis study aimed to compare the parameters of CBP and PBP measurements, arterial stiffness, TOD and renal profile in patients with anti-hypertensive treatment guided by CBP or PBP targets.MethodsA randomized clinical trial was conducted in central group (CG) and peripheral group (PG). Patients were randomized, evaluated every 3 months for BP and antihypertensive adjustments during a one-year follow up. The procedures in V1 and V5: anthropometric assessment; CBP/PBP measurements, carotid ultrasound; echocardiography; laboratory tests. Paired and unpaired t-tests and the χ2 were used (significance level: 5%).ResultsThe study evaluated 59 participants (30CG/29PG). The augmentation index (AIx) was higher in the CG (27.3% vs. 20.3%, p = 0.041). Intergroup analysis has found central diastolic BP lower in the CG (78.9 vs. 84.3 mmHg, p = 0.024) and the Alx difference between groups ceased to exist after a one-year follow-up. Intragroup comparisons, after intervention, showed a lower frequency of changed PWV (p < 0.001) and LVMI (p = 0.018) in the CG. The PG showed a higher frequency of changed PWV (p < 0.001) and LVMI (p = 0.003).ConclusionThe intervention guided by central BP reduced the central diastolic BP and AIx compared to the PG. There was a reduction in the frequency of changed PWV and LVMI in the CG.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1247146/fullarterial stiffnesscentral blood pressureclinical trialhypertensionpulse wave velocity |
| spellingShingle | Gilberto Campos Guimarães Filho Priscila Valverde de Oliveira Vitorino Sayuri Inuzuka Adriana Sebba Barroso Robson Pierre Pacífico Alves Filho Victoria Alves Melo Luiz Fernando de Oliveira Urzeda Ana Luiza Lima Sousa Antonio Coca Paulo César Brandão Veiga Jardim Weimar Kunz Sebba Barroso Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies Frontiers in Cardiovascular Medicine arterial stiffness central blood pressure clinical trial hypertension pulse wave velocity |
| title | Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies |
| title_full | Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies |
| title_fullStr | Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies |
| title_full_unstemmed | Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies |
| title_short | Pharmacological treatment of hypertension guided by peripheral or central blood pressure: a comparison between the two strategies |
| title_sort | pharmacological treatment of hypertension guided by peripheral or central blood pressure a comparison between the two strategies |
| topic | arterial stiffness central blood pressure clinical trial hypertension pulse wave velocity |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1247146/full |
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