P167 DIFFERENCES IN PULSE WAVE VELOCITY ESTIMATED USING TOTAL ARTERIAL COMPLIANCE BETWEEN SUBTYPES OF ARTERIAL HYPERTENSION

Background and Objective: Different clinical phenotypes of arterial hypertension (AH) are identified through current oscillometric blood pressure (BP) measurements. Recently, our group described hemodynamic characteristics of AH subtypes utilizing 24-hour ambulatory blood pressure monitoring (24-h ABPM). It remains unclear whether differences in PWV exist among AH subtypes, which could potentially enhance diagnostic accuracy and guide antihypertensive treatment selection. The objective was to assess the relationship between PWV, estimated using Ct, and AH subtypes. Methods: A cross-sectional study was conducted, involving 13,027 untreated patients referred for 24-h ABPM. PWV was estimated using a novel method based on Ct, derived from BP and heart rate measurements obtained during 24-h ABPM. This estimation method was developed based on the relationship between Ct and PWV as described by Vardoulis et al., utilizing the Bramwell-Hill theory and experimental research. The formula used for PWV estimation was PWV = √(36.7/(Ct/(log[age]))). Results: Among the participants, 46.5% were men, with an average age of 50.2±14.1 years and a body mass index of 27.1±4.1 kg/m 2 . Isolated systolic hypertension (ISH) (3.9%) exhibited the highest arterial stiffness, with the highest PWV (10.2±1.4 m/s) and pulse pressure (PP) (60.0±6.6 mmHg), and the lowest Ct (0.67±0.16 mL/mmHg). In contrast, isolated diastolic hypertension (IDH) (26.3%) showed the lowest PWV (7.9±0.8 m/s) and PP (40.6±3.6 mmHg), and the highest Ct (1.01±0.18 mL/mmHg). As Ct decreased, PWV increased. Thus, PWV based on Ct from 24-hour ABPM showed clear differences between AH subtypes (ANOVA; p value < 0.001) (Figure). Conclusions: PWV is related with AH subtypes, exhibiting a progression from IDH to ISH. Patients with IDH typically have the lowest PWV, whereas those with divergent systolic-diastolic hypertension (D-SDH) and ISH have the highest PWV values. These findings underscore the significance of Ct in determining PWV values and carry diagnostic and prognostic implications concerning arterial function across various AH subtypes.