P-56: Utility of a computer program (GARAPA) for the objective classification of alterations of arterial blood presure profiles

• Published in: American journal of hypertension Vol. 14; no. S1; pp. 47A - 48A
• Main Authors: Sarrias, Xavier, Diez-Noguera, Antoni
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2001
• Subjects: awake surge; Blood Pressure monitoring; hypertension
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1016/S0895-7061(01)01534-5

In the 15th ASH Scientific Meeting, we presented a program (GARAPA) for the management and the analysis of ambulatory records of arterial blood pressure (ABP). The program incorporates accurate and sophisticated methods of analysis under a chronobiological approach. Other characteristics, such as the compatibility with most major ABP monitors (Spacelab, Takeda, Profilomat, etc.) and the possibility to perform the analysis in four user-defined time intervals, facilitates the automatic classification of the alterations of ABP profiles in large groups of patients, applying objective criteria from several recommendations existing in the current literature (Owens et. al., J Hypertension, 16:1735-1743, 1998). In this paper we show how, after using GARAPA for the analysis and storage of the records of ABP, it is possible to establish differences between four groups of patients on the basis of the differentiated analysis of specific time intervals. The study was carried out with a sample of 676 untreated patients. Subjects were classified according to the following criteria: people with both systolic and diastolic “day means” above 140 and 90 are the “hypertense group” (HT) and people having both “night means” at least a 10% lower than the “day means” are the “dipper group” (DIPP). The other groups are “normotense” (NT) and “non dippers” (NDIP). Applying these criteria, four groups were obtained. Sampling interval was 15 minutes, using Spacelab 90207and Profilomat monitors. Four time intervals were defined for the analysis: the first two hours of the record (1), day time (2), night time (3) and the two hours after wake up (4). Overloads and other derived indexes were calculated from the areas over time qualified thresholds: 140/90 mmHg for the awake time and 120/80 during the sleeping time. Many indexes clearly show significant differences between the four groups. As an example, the systolic and diastolic mean values during the awake surge (interval 4), show highly statistically significant differences (p<0.001) between the groups. Mean values of systolic and diastolic ABP for the groups HT-DIPP, HT-NDIP, NT-DIPP and NT-NDIP are: 143.3/89.4, 157.4/94.6, 127.5/80.4 and 133.0/84.2 mmHg respectively. It's worth noticing that in both groups (NT and HT) this value is higher in the NDIP than in the DIPP patients. Likewise, the differences found in many other indexes allow the objective identification of the different pathology groups.