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

2. 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

3. 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)

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

5. 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.

6. 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

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