THE ASSOCIATION BETWEEN ESTIMATED PULSE WAVE VELOCITY AND MASKED HYPERTENSION: RESULTS FROM THE HUNGARIAN AMBULATORY BLOOD PRESSURE MONITORING REGISTRY

Objective: Arterial stiffening can anticipate the development of hypertension. Estimated pulse wave velocity (ePWV) can provide an acceptable approximation of the progression of arterial stiffness. The aim of our study was to explore the utility of ePWV to predict masked hypertension (MH) in untreated patients or masked uncontrolled hypertension (MUCH) in treated ones with optimal, normal or high-normal office blood pressure (oBP), to help patient selection for ambulatory blood pressure monitoring (ABPM). Design and method: Data of the Hungarian ABPM Registry between September 2020 and November 2023 were used in our analysis. ePWV was calculated based on previously published formulas. Results: Out of 38 720 uploaded ABPM curves with clinical data, 7386 participants had optimal, normal or high-normal oBP. 5644 (76.4%) of them were on regular antihypertensive medication. MH or MUCH were diagnosed with ABPM in 4348 cases. Mean ePWV was 9.27±2.02 m/s, which did not differ in MH/MUCH or non-MH/MUCH groups (9.28±1.98 m/s and 9.25±2.07 m/s, respectively). In MH/MUCH group male sex and obesity were more frequent compared to non-MH/MUCH (46.1% versus 28.1% and 23% versus 14.6% respectively, p<0.05). In a model adjusted for male sex and obesity, ePWV>8 m/s was independently associated with MH/MUCH in the total population (adjusted odds ratio (aOR):1.15 (95% confidence interval (CI):1.04-1.27), B=0.140, p=0.007). This association was more pronounced separately in MH subjects (aOR:1.44 (95%CI: 1.18-1.76), B=0.365, p<0.001), where the model had 40.3% sensitivity and 78.7% specificity, while it was missing in MUCH. Conclusions: Besides normal oBP categories ePWV>8 m/s can be a marker of MH, thus can help in patient selection for ABPM.