BEAUTY Trial: Hypertension Control Not Improved with Hemodynamic Monitoring From ESH 2016 | LB 3: Pierre Boutouyrie, MD, PhD INSERM, Université Paris Descartes, Paris, France

Overview Impedance-guided therapy with the Hotman device (IHM) did not improve central blood pressure (CBP) or pulse wave velocity (PWV) compared with control in new analysis of BEAUTY study Study designed to determine if a drug selection algorithm driven by data from noninvasive hemodynamic profiles would improve CBP or PWV CBP and PWV measured with applanation tonometry using Sphygmocor system 115 of the 167 patients in BEAUTY included in analysis aged 64 years, median 3 antihypertensive medications, average systolic blood pressure (SBP) with ambulatory monitoring 143 mmHg

Results at 6 Months Marked, significant reduction in central SBP in both groups, no between-group difference (Figure 1) Marked, significant reduction in central pulse pressure in both groups, no between-group difference (Figure 1) Slightly higher values for augmentation index with IHM, but no between-group difference No between-group difference for amplification, a measure of peripheral-central SBP Significant improvement in PWV with IHM, but no significant between-group difference after adjustment for within-trial SBP (Figure 2)

Figure 1. Changes in Central Systolic Blood Pressure in BEAUTY Study mmHg p<0.001 versus baseline p=0.96 IHM, integrated hemodynamic management.

Figure 2. Changes in Pulse Wave Velocity in BEAUTY Study m/s Baseline SBP: p<0.001 Within trial changes in SBP: p=0.02 IHM, integrated hemodynamic management.

Conclusions Monitoring hemodynamic parameters with a predefined algorithm for drug selection did not improve CBP or PWV in patients with hypertension Similar improvements were observed for central blood pressure, wave reflections, and amplification, Changes in pulse wave velocity were parallel to improvements in blood pressure with each treatment approach

BEAUTY Trial: Hypertension Control Not Improved with Hemodynamic Monitoring From ESH 2016 | LB 3: Pierre Boutouyrie, MD, PhD INSERM, Université Paris Descartes, Paris, France