P165 HEMODYNAMIC PROFILES OF ISOLATED DIASTOLIC HYPERTENSION IN AMBULATORY BLOOD PRESSURE MONITORING

Background and Objective: Isolated diastolic hypertension (IDH) is a prevalent form of high blood pressure (BP), especially among young individuals. Yet, its association with cardiovascular disease risk and the necessity of treatment remain subjects of ongoing debate. Our research endeavors to elucidate hemodynamic profiles using a non-invasive method applied to 24-hour ambulatory blood pressure monitoring (24-h ABPM). However, uncertainty persists regarding whether distinct hemodynamic profiles exist within IDH patients, considering they are characterized by normal total arterial compliance (Ct). This study aims to shed light on potential variations in hemodynamics within the IDH population, providing valuable insights for personalized treatment. Methods: A cross-sectional study was conducted, involving 7,202 patients referred to an outpatient cardiology center for suspected arterial hypertension. These patients underwent 24-h ABPM. The study included individuals over 18 years old without a prior diagnosis of hypertension and not taking antihypertensive medication. Two groups were included: those with IDH, defined as diastolic blood pressure >80 mmHg (24-h ABPM), and those with normotension. Hemodynamic parameters were estimated using a published method to estimate Ct. Silhouette analysis determined the number of underlying groups within the IDH cohort, while cluster analysis classified these subgroups. Results: Among the participants, 59.0% were female, with an average age of 49.0±14.0 years. Of the total patients included, 3,424 (47.5%) had isolated diastolic hypertension (IDH). Silhouette analysis effectively distinguished two groups. Group IDH-1 exhibited normal Ct and systemic vascular resistance (SVR), elevated heart rate (HR), and higher cardiac index (CI) (P value <0.001). Conversely, group IDH-2 demonstrated high Ct and SVR, lower HR, and CI (P value <0.001) (Table). Conclusions: The delineation of two distinct hemodynamic profiles within IDH is significant. The first group demonstrates a cardiogenic hypertension profile, indicated by elevated CI, whereas the second group presents a profile characterized by heightened SVR. These contrasting hemodynamic patterns offer valuable insights for tailoring treatment strategies to individual patient needs. Table. Comparison of hemodynamic variables between normotensives (NT) and two isolated diastolic hypertension (IDH) profile, utilizing ANOVA for statistical analysis.