open access

Vol 70, No 6 (2012)
Original articles
Published online: 2012-06-20
Submitted: 2012-12-28
Get Citation

Usefulness of impedance cardiography in optimisation of antihypertensive treatment in patients with metabolic syndrome: a randomised prospective clinical trial

Paweł Krzesiński, Grzegorz Gielerak, Jarosław Kowal, Katarzyna Piotrowicz
Kardiol Pol 2012;70(6):599-607.

open access

Vol 70, No 6 (2012)
Original articles
Published online: 2012-06-20
Submitted: 2012-12-28

Abstract


Background: The effective antihypertensive therapy is one of the main goals of treatment in metabolic syndrome (MS) because hypertensive patients with MS are of high cardiovascular risk. The impedance cardiography (ICG), as a modern technique of non-invasive haemodynamic monitoring, enables the evaluation of cardiac index (CI), thoracic fluid content (TFC) and systemic vascular resistance index (SVRI) and seems to be useful in clinical individual assessment of patients with MS.
Aim: To estimate the effectiveness of the antihypertensive therapy based on ICG.
Methods: The study involved 82 hypertensive patients with MS (57 men, age 45.5 ± 10.0 years), without any major chronic diseases. After the preliminary assessment including office blood pressure measurement (OBPM), ambulatory blood pressure monitoring (ABPM) and ICG, the subjects were randomised into two groups: empirical (GE) and treated with the use of haemodynamic evaluation by ICG (HD). The effect of the therapy was estimated at 3 months follow-up.
Results: After 12 weeks the HD group was characterised by lower mean BP values in OBPM and ABPM, with statistical significance for night-time SBP (120.6 ± 9.1 vs 115.6 ± 8.2 mm Hg, p = 0.036). The use of ICG significantly increased the reduction of BP in OBPM — SBP (GE vs HD: change 10.7 vs 18.1 mm Hg, p = 0.012), DBP (8.9 vs 12.2 mm Hg, p = 0.037), and ABPM: in the 24-h period SBP (10.5 vs 16.7 mm Hg; p = 0.013) and day-time SBP (10.5 vs 17.2 mm Hg, p = 0.009). More patients in the HD group reached recommended BP control in OBPM (23.5 vs 36.6%, p = 0.222) and ABPM (23.5 vs 43.9%, p = 0.117).
Conclusions: The antihypertensive therapy guided by ICG increased the reduction of BP in patients with MS. The assessment of haemodynamic profile by ICG guarantees better choice of antihypertensive drugs and subsequently increases the chance of recommended BP control in patients with MS.

Abstract


Background: The effective antihypertensive therapy is one of the main goals of treatment in metabolic syndrome (MS) because hypertensive patients with MS are of high cardiovascular risk. The impedance cardiography (ICG), as a modern technique of non-invasive haemodynamic monitoring, enables the evaluation of cardiac index (CI), thoracic fluid content (TFC) and systemic vascular resistance index (SVRI) and seems to be useful in clinical individual assessment of patients with MS.
Aim: To estimate the effectiveness of the antihypertensive therapy based on ICG.
Methods: The study involved 82 hypertensive patients with MS (57 men, age 45.5 ± 10.0 years), without any major chronic diseases. After the preliminary assessment including office blood pressure measurement (OBPM), ambulatory blood pressure monitoring (ABPM) and ICG, the subjects were randomised into two groups: empirical (GE) and treated with the use of haemodynamic evaluation by ICG (HD). The effect of the therapy was estimated at 3 months follow-up.
Results: After 12 weeks the HD group was characterised by lower mean BP values in OBPM and ABPM, with statistical significance for night-time SBP (120.6 ± 9.1 vs 115.6 ± 8.2 mm Hg, p = 0.036). The use of ICG significantly increased the reduction of BP in OBPM — SBP (GE vs HD: change 10.7 vs 18.1 mm Hg, p = 0.012), DBP (8.9 vs 12.2 mm Hg, p = 0.037), and ABPM: in the 24-h period SBP (10.5 vs 16.7 mm Hg; p = 0.013) and day-time SBP (10.5 vs 17.2 mm Hg, p = 0.009). More patients in the HD group reached recommended BP control in OBPM (23.5 vs 36.6%, p = 0.222) and ABPM (23.5 vs 43.9%, p = 0.117).
Conclusions: The antihypertensive therapy guided by ICG increased the reduction of BP in patients with MS. The assessment of haemodynamic profile by ICG guarantees better choice of antihypertensive drugs and subsequently increases the chance of recommended BP control in patients with MS.
Get Citation

Keywords

metabolic syndrome; arterial hypertension; impedance cardiography

About this article
Title

Usefulness of impedance cardiography in optimisation of antihypertensive treatment in patients with metabolic syndrome: a randomised prospective clinical trial

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 70, No 6 (2012)

Pages

599-607

Published online

2012-06-20

Bibliographic record

Kardiol Pol 2012;70(6):599-607.

Keywords

metabolic syndrome
arterial hypertension
impedance cardiography

Authors

Paweł Krzesiński
Grzegorz Gielerak
Jarosław Kowal
Katarzyna Piotrowicz

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl