#2829 Orthostatic blood pressure reduction is associated with renal organ damage in fit elderly patients with arterial hypertension

Abstract Background and Aims Blood pressure (BP) has specific characteristics in older patients. We evaluated the association of positional changes in BP during orthostatism with the presence of hypertension-mediated organ damage (HMOD) in elderly fit hypertensive patients. Method This was a multicenter and cross-sectional study of 156 hypertensive patients aged 75 ± 5.9 years (49% women). Office and 24-hour central and peripheral BP were measured with an oscillometric device. BP changes induced by the standing position were reported according to the conventional definition of orthostatic hypotension (OH) and as a continuous variable (supine – orthostatic BP). We classified patients into two groups depending on orthostatic BP changes, below or above the median of the distribution. HMOD was assessed as renal (reduction of glomerular filtration rate and/or increase in albuminuria), cardiac [left ventricular hypertrophy (LVH)], and arterial (increased aortic pulse wave velocity). Results OH was present in 33 patients (21.1%), whereas orthostatic BP change presented a wide distribution. A total of 145 patients (92.9%) had HMOD (49.3% kidney disease, 48% LVH, and 81.4% arterial stiffness). All patients with OH had HMOD involvement and significantly higher values of all systolic BP estimates. Although OH and HMOD were not significantly associated, the analysis of orthostatic BP changes showed greater renal damage in the group with BP reduction above the median compared to those with BP reduction below the median, after adjustment for age, gender, the presence of previous cardiovascular event, office BP, and alpha-blocker treatment (P < 0.05). Conclusion Orthostatic BP reduction is associated with renal damage in elderly fit hypertensive patients.