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Updated: Sep 6, 2025
Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
Non-invasive haemodynamic assessments among hypertensive patients in a routine family doctor's office
Bartosz Gabriel Trzeciak1, Piotr Gutknecht1, Natalia Marek-Trzonkowska1,2
1Department of Family Medicine, University Centre for Cardiology, Medical University, Gdansk, Poland.
Insights
Many patients struggle with hypertension control due to mismatched treatments. Impedance cardiography (ICG) may help tailor therapy by identifying hemodynamic types in hypertension patients.
Area of Science:
- Cardiology
- Clinical Physiology
- Medical Technology
Background:
- Difficult-to-control hypertension often results from a mismatch between the patient's hemodynamic profile and prescribed antihypertensive medications.
- Impedance cardiography (ICG) offers a potential method for individualizing hypertension treatment by assessing hemodynamic parameters.
Purpose of the Study:
- To investigate the distribution of hemodynamic types among patients with hypertension in an outpatient setting.
- To explore the relationship between hemodynamic profiles and the control status of hypertension.
Main Methods:
- A prospective, observational study involving 189 patients with primary hypertension.
- A 10-minute impedance cardiography (ICG) examination was conducted.
- Patients were categorized based on blood pressure control (well-controlled vs. poorly controlled) and hemodynamic states.
Main Results:
- Poorly controlled hypertension was associated with higher vascular resistance (41.1% vs. 27.7%, p=0.037) compared to well-controlled hypertension.
- A significant proportion of patients (half) did not meet therapeutic blood pressure goals.
- Fluid retention was noted as a factor in poorly controlled hypertension.
Conclusions:
- A substantial number of hypertension patients do not achieve treatment targets.
- Significant differences in hemodynamic states exist between well-controlled and poorly controlled hypertension groups.
- Impedance cardiography-guided, individualized treatment strategies show promise for improving hypertension management.
Introduction And Objective:
Difficult-to-control blood pressure can be attributed to a mismatch between the haemodynamic type of hypertension and the drug class used in treatment. Impedance cardiography may be a useful tool for enabling the individualization of antihypertensive therapy. The aim was to investigate the distribution of haemodynamic types of HT among hypertensive patients in an outpatient clinic.
Material And Methods:
This was a prospective, observational study of patients with primary hypertension at an outpatient clinic. A 10-minute ICG examination was performed in 189 consecutive, patients (118 men and 71 women). Patients were divided into groups based on whether their hypertension was well-controlled (140/90 mmHg, n=95). They were also stratified according to haemodynamic states.
Results:
Patients with poorly controlled blood pressure compared to patients with well controlled blood pressure had a high haemodynamic output in 6.3% vs. 2.1% (p=0.153), and high vascular resistance in 41.1% vs. 27.7% (p=0.037), and balanced haemodynamic states in 52.6% vs. 70.2% (0 80 beats/min) and fluid retention (p<0.01).
Conclusions:
Half of the examined patients did not achieve the therapeutic goals for hypertension treatment. Differences in haemodynamic state of well and poor controlled hypertension groups suggests the usefulness of impedance cardiography-targeted hypertension treatment.
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