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RELATIONSHIP BETWEEN AMBULATORY PULSE PRESSURE AND CENTRAL OBESITY IN HEALTHY SUBJECTS AND IN PATIENTS WITH ESSENTIAL HYPERTENSION: PP.25.04

Introduction: Progressive stiffening of large arteries predicts cardiovascular mortality as indicated by the relationship between estimated pulse pressure (PP) with ambulatory blood pressure monitoring (ABPM) and cardiac and vascular damage. Central obesity (CO) is related to cardiovascular risk but, at present, it is unknown if abdominal fat accumulation is associated with increased PP in healthy and hypertensive patients. Objective: Analyse the relationship between PP derived from ABPM and CO by anthropometric parameters in healthy and hypertensive patients. Methods: We studied 220 outpatients (115 male; 105 female) attending to our Department of Internal Medicine, antihypertensive therapy free, with a mean age of 54.60 ± 12.89 years, BMI (kg/m2) 26.16 ± 3.72, waist circumference (WC) (cm) 94.81 ± 10.83 cm and waist to height ratio (WHtR) (cm/cm) 0.563 ± 0.06. The occurrence of CO was evaluated according to NCEP-ATP III criteria (WC > 102 cm in men and > 88 cm in women). Results: In patients with CO (n = 87) we found elevated 24-hour PP (58.23 ± 11.36 vs 50.96 ± 9.20 mmHg, p < 0.0001), 24-hour systolic blood pressure mean (142 ± 12.93 vs 130.56 ± 12,0 mmHg, p < 0.0001), and 24-hour diastolic blood pressure mean (83.76 ± 8.71 vs 79.56 ± 7.57 mmHg, p < 0.001). Interestingly, we also found a progressive increase in WHtR value from the first to the third tertile of the distribution of ambulatory PP (chi-square2 42.30 p < 0.0001). Furthermore, we found a direct correlation between WC and PP in all subjects (p < 0.0001). Conclusions: Our data show an association between PP evaluated by ABPM and obesity overall present in patients with CO. Furthermore, the direct correlation between WC and 24-hour PP mean suggest that these measures can be used as additional tools in assisting risk stratification in hypertensive patients.