Background/Aims: Arterial wall stiffness is considered as independent cardiovascular risk factor. Aim of this study was to compare arterial stiffness assessed by use of Pulse Wave Analysis (PWA) and carotid - femoral Pulse Wave Velocity (PWV) in resistant hypertensive patients to essential hypertensive patients and to normotensive control subjects (NCS).

Methods: 29 patients with resistant hypertension (RH), 35 patients with moderate to severe essential hypertension (EH) and 29 NCS were investigated. PWA and PWV were obtained using SphygmoCor applanation tonometer.

Results: PWV was significantly higher in RH group when compared to EH group and to NCS group while clinical blood pressure was comparable between RH and EH groups. However, 24h ABPM values were significantly higher in RH group than in EH group. There were no significant differences in age, duration of hypertension, body mass index (BMI), lipid profile, fasting glucose levels and creatinine levels between RH and EH groups. Carotid ultrasound and echocardiographical findings were comparable between RH and EH groups. PWV correlated with the presence of the diagnosis of RH, age, clinical SBP, brachial pulse pressure, mean 24h SBP, mean day SBP and mean night SBP. After multiple regression analysis, PWV remains significantly correlated only with the presence of the diagnosis of RH, age and with brachial pulse pressure.

Conclusions: Patients with RH have increased arterial wall stiffness, represented by carotid-femoral PWV, when compared to EH patients. The greatest determinants of PWV are the presence of RH, age and brachial pulse pressure.