Hemodynamic-Guided Therapy is Associated with Better Hypertension Control Compared with Standard Care: A Comparative...

Blood pressure abnormalities are common in patients with heart-related conditions and substantially increase morbidity and mortality. This retrospective comparative study evaluated the value of a hemodynamic-guided therapy (HGT) intervention on systolic and diastolic blood pressure (SBP, DBP) compared with standard care.

We retrospectively analyzed 156 patients with cardiovascular disease (HGT, n = 107; control, n = 49). SBP and DBP were measured at baseline and after treatment using standardized noninvasive hemodynamic monitoring. Hemodynamic parameters (including cardiac output, systemic vascular resistance, and total body fluids were used to guide medication selection and titration in the HGT group. Normality of paired difference scores was assessed with the Shapiro-Wilk test, and within‑group comparisons were performed with paired t‑tests. Categorical comparisons used chi‑square tests. Statistical significance was set at two‑sided p < 0.05.

Post‑treatment assessments showed significant reductions in both SBP and DBP in the HGT group but not in the control group. Among women receiving HGT, the mean post‑treatment SBP was 133.8 mmHg (baseline to post-treatment change, p < 0.001); among men receiving HGT, the mean post‑treatment SBP was 131.6 mmHg versus 150.5 mmHg at baseline (p < 0.001). DBP in women receiving HGT decreased to a mean of 74.2 mmHg, and in men to 74.7 mmHg from 85.5 mmHg at baseline (both p < 0.001). No significant SBP or DBP changes were observed in the control arm.

In this retrospective analysis, hemodynamic‑guided therapy was associated with significant improvements in systolic and diastolic blood pressure compared with standard care. Using individualized hemodynamic profiles to guide medication selection and dosing may improve blood pressure control in patients with hypertension and cardiovascular comorbidities; prospective studies are warranted to confirm these findings.