Dynamics of blood pressure rates and arterial stiffness among patients 75 years plus receiving retard indapamide monotherapy

Markova M. A., Kotovskaya Yu. V., Kobalava Zh. D.
ThePeoples' Friendship University of Russia, GKB №64, Moscow, Russia

Purpose: Study dynamics of blood pressure (BP), rates of arteries elasticity against retard indapamide intake (1,5 mg per day) among patients 75 years plus.
Materials and methods: 40 patients (11 male and 29 female) were inspected older than 75 years old (average age 80,7 ± 0,47 years) with hypertension II-III grade who had no cardiovascular complications in case history and who didn’t go through antihypertensive therapy. Everybody was taking retard indapamide (1,5 mg per day) within 12 weeks. Ambulatory blood pressure rates BP (ABPM) and pulse transit time (PTT) were measured with the use of device MnCDP-3 (OOO “Petr Telegin”, Nizhny Novgorod).
PTT is a an arterial stiffness index – it is calculated as time from aortic valve-opening and R-wave appearance in ECG till beginning of pulse wave front, registered by oscillometric method.
Pulse wave transit speed (PWTSBcf) between carotid and femoral arteries, shoulder and shank (PWTSBba) and cardio-malleolar-vascular index (CMVI) were tested with the use of vascular screening system VS 1000 VaSera, Fukuda Denshi, Japan. The data is presented as M ± SD. Differences and correlations were considered to be veracious at p<0,05.

Results: Clinical arterial pressure decreased from 165,8 ± 1,81/86,5 ± 1,3 to 147,2 ± 0,98/76,1 ± 0,79 mmHg, decreased pressure 78,3 ± 1,58 to 71,2 ± 0,88 mmHg; 24 hour arterial pressure from 145,6 ± 1,75/76,3 ± 0,89 to 133,6 ± 0,98/69,3 ± 3,8 mmHg; SAPd from 147,2 ± 1,8/77,1 ± 0,87 to 135,4 ± 1,04/73,4 ± 2,4 mmHg, SAPn from 132,82 ± 2,2/71,9 ± 1,39 to 126,7 ± 1,45/71,1 ± 1,1 mmHg  against retard indapamide therapy. Hypotensive effect was accompanied by PWTSBba decrease from 23,1 ± 0,53 to 16,74 ± 0,35 m/s, PWTSBcf decrease from 12,1 ± 0,34 to 7,4 ± 0,21 m/s; PTT increase 100-60 from 157,6 ± 1,38 to 167 ± 5,4 m/s, p<0,05. CMVI didn’t change during medical treatment and didn’t depend on arterial pressure rates (9,1 ± 0,4 and 8,1 ± 0,26). Direct relation between decrease of clinical systolic arterial pressure (SAP) and its average rate during ABPM and PWTSBcf (r=0,45) and PWTSBba (r=0,47), inverse relation between SAP-24 and PTT100-60 (r= - 0,47).