Clinical Research
Clinical Research Papers
The Compliance Versus Pulse
Pressure Relation: A Potential Indicator of Decreased Load
Adaptions in Hypertension
Brinton TJ, Neutel JM, Chio S-S, Walls
ED, Tai L-C, Franklin SS, Smith DHG, Weber MA, UCI, Orange, CA,
and Pulse Metric, Inc. San Diego, CA.
Since
blood pressure may be influenced by changing hemodynamics,
arterial compliance (C, ml/mmHg) may be a more reliable marker of
underlying cardiovascular disease. However, C includes a
functional (hemodynamic) component which may complicate
measurement interpretation. We have previously reported a strong
inverse correlation between C and pulse pressure (PP) during
24-hour ambulatory monitoring with the DynaPulse 5000A. Utilizing
the same methodology, we evaluated 18 age and BMI matched
patients [9 normotensive (NT) (24-hour, 127±
2/66± 2 mmHg), (mean± sem), 9 medicated hypertensives (HT)
(24-hour, 140± 5/73± 2 mmHg)]. In order to evaluate C
measurements independent of the functional component, the two
groups were matched for hemodynamic measurements (132/70, MAP=88,
PP=63). C measurements were significantly higher in the NT group
(n = 431, 0.121± 0.002) versus the HT
group (n=431, 0.108± 0.001,
p<0.001). The C vs. PP correlation was best fit in both NT and
HT by a power function (y = 5.69x-0.940 vs. 1.15x-0.584).
Although the functions were similar at high PP, the HT function
diverged significantly at low PP suggesting a difference in load
adaption. The data suggests that since PP is a hemodynamic
functional variant, the structural and functional components of
compliance may be evaluated separately using the PP vs. C
function derived by ambulatory monitoring. The evaluation of
structural compliance independent of functional factors may be a
more reliable screening tool for the early detection of
hypertension and cardiovascular disease.
*Presented at the American Society of
Hypertension 11th Annual Scientific Meetings, 1996.
|
