OS 20-03 THE ASSOCIATIONS BETWEEN EACH COMPONENT OF BLOOD PRESSURE AND TARGET ORGAN DAMAGES IN PATIENTS AT HIGH RISK OF CORONARY ARTERY DISEASE.

OBJECTIVE: Data from systemic evaluation of the influence of each component of blood pressure (BP) on various target organ damages (TODs) has been limited. This study was performed to elucidate which BP component was associated with TODs in patients with high risk of coronary artery disease (CAD).

DESIGN AND METHOD: Study data were obtained from a nation-wide registry, composed of 652 patiens (471 women with 58.4 ± 10.5 year old) with suspected CAD who underwent invasive coronary angiography (CAG). The associations between each brachial BP component [systolic and diastolic BP (SBP and DBP), mean arterial pressure (MAP) and pulse pressure (PP)] and [left ventricular mass index (LVMI), estimated glomerular filtration rate (eGFR), left ventricular filling pressure (E/e') and CAD] were analyzed.

RESULTS: A total of 219 patients (21.9%) had obstructive CAD (≥ 50%) in CAG. In univariate analysis, only DBP was correlated with LVMI, and SPB with eGFR, but these correlations disappeared in multivariable analyses. SBP (r = 0.227), MAP (r = 0.135) and PP (r = 0.257) had significant and positive linear correlations with E/e' (P < 0.05 for each). These correlations remained even after controlling for potential confounders. SBP and PP were the independent predictors for obstructive CAD, on the other hand, DBP and MAP were not associated with obstructive CAD.

CONCLUSIONS: Among middle-aged and elderly Korean patients at high risk of CAD, each BP component had a different influence on TODs. Targeting SBP and PP rather than DBP and MAP is possibly more efficient in preventing LV diastolic dysfunction and CAD in this group of patients.