Value of Noninvasive Hemodynamics to Achieve Blood Pressure Control in Hypertensive Subjects

Abstract

Abnormal hemodynamics play a central role in the development and perpetuation of high blood pressure. We hypothesized that hypertension therapy guided by noninvasive hemodynamics with impedance cardiography could aid primary care physicians in reducing blood pressure more effectively. Uncontrolled hypertensive patients on 1 to 3 medications were randomized by 3:2 ratio to either a standard arm or hemodynamic arm that used impedance cardiography (BioZ, CardioDynamics). Each patient completed 5 study visits with a 2-week washout period followed by 3 months of treatment. A total of 164 patients from 11 centers completed the study, 95 in the standard arm and 69 in the hemodynamic arm. At baseline and after washout, there were no differences between arms in number of medications or demographic, blood pressure, or hemodynamic characteristics. Systolic blood pressure reductions in the hemodynamic arm were greater from baseline (19 mm Hg versus 11 mm Hg; P<0.01) and after washout (25 mm Hg versus 19 mm Hg; P<0.05...