Diabetes, Obesity & Heart

Background: Hypertension is an important risk factor for cardiovascular events, stroke and kidney disease, optimal hypertension control still a controversial subject in medical literature, several studies proposed the hypertension control calculating hemodynamic parameters.

Materials and Methods: In the present study we recruited 84 patients’ males (34%) and females (49%) between 32 and 95 years of age with non-controlled hypertension taken 2 or more medications and measured heart rate (HR), systolic (SBP), diastolic (DBP) and mean (MAP) blood pressure, pulse pressure (PP), cardiac index (CI) using Liljestrand & Zander modified formula to calculate stroke volume (CI = [HR*(PP/MAP)]/Body surface area), central venous pressure (CVP) using inferior vena cava diameter (IVCD), systemic

vascular resistance index (SVRi = MAP/CI*80) and divided in six hemodynamic groups Hyperdynamics (Hd) were those with CI >3,5L/min/m2, High Resistance (Hr) group when SVRi > 2500 dynas, Fluid overload (FO) when CVP > 8 cm H2O or IVCD > 2 cm andmixed types, Hd + Hr, Hd + FO and Hr + FO, a basal values was measured after 1 week washout with captopril, after washout treatment was selected according hemodynamic groups with a 6 months follow up.

Results: We found a statistical significant reduction of all parameters at the first month after treatment and hypertension control according European of Society Cardiology guidelines in 100% of patients at 3rd month of treatment with hemodynamic normalization, only Hd + FO at 6th month, with no symptomatic hypotension.

Conclusion: Hemodynamic guided treatment to control high blood pressure had good results in this study; however, bigger trials are

needed to prove his efficacy.