P804The significance of 24h blood pressure variability improvement regarding target organ damage indices three years after medical treatment initiation in essential hypertension

Abstract Background Blood pressure variability (BPV) has been associated with development, progression and severity of cardiac and vascular organ damage and with an increased risk of cardiovascular events and mortality, independently adding to cardiovascular risk, over and above the contribution of elevated mean BP levels. We aimed to explore any correlation between differences in BPV and target organ damage indices (TOD) in hypertensive patients three years after medical treatment initiation. Methods At baseline and before medical treatment initiation, we measured 24h average SBP and DBP as well as 24h systolic BPV after 24h ambulatory blood pressure monitoring (ABPM) in newly diagnosed and never treated hypertensive patients (n=171, mean age=52+12 years, 110 males, 24h average SBP/DBP=138+10/87+9 mmHg, 24h systolic BPV=15+3) who were also subjected to arterial stiffness by carotid-femoral pulse wave velocity (PWV), left ventricular hypertrophy by left ventricular mass index (LVMI) and coronary flow reserve (CFR) estimations. All the above tests were repeated approximately three years later after treatment initiation. Results Patients were characterized as controlled (n=113, mean age=54+12 years, 62 males, 24h average SBP/DBP=118+6/71+6 mmHg) or non-controlled hyperensives (n=58, mean age=48+11 years, 48 males, 24h average SBP/DBP=133+8/83+7 mmHg) based on ABPM results three years later (controlled BP=24h average BP<130/80 mmHg). In the whole population, 24h average SBP/DBP, systolic BPV (p<0.001) and LVMI (p=0.01) were decreased while systolic BPV difference was related with LVMI difference (r=0.27, p<0.001). In controlled hypertensives, 24h average SBP/DBP, systolic BPV (p<0.001) and LVMI (p=0.02) were decreased while systolic BPV difference was related with LVMI difference (r=0.35, p<0.001). In non-controlled hypertensives, 24h average SBP (p=0.001), DBP p<0.001) and systolic BPV (p=0.04) were decreased while PWV was increased (p=0.03) and no correlations were found between systolic BPV and TOD. Correlation between BPV and LVMI Conclusions It seems that antihypertensive-induced systolic BPV improvement relate with cardiovascular risk decrease occur only in the setting of blood pressure treated within normal limits and confirmed by ABPM. Our study confirms that left ventricular mass between other TOD primarily improves due to successful antihypertensive treatment.

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THE SIGNIFICANCE OF 24H BLOOD PRESSURE VARIABILITY DIFFERENCES REGARDING TARGET ORGAN DAMAGE INDICES THREE YEARS AFTER MEDICAL TREATMENT INITIATION IN ESSENTIAL HYPERTENSION

Journal of Hypertension ◽

10.1097/01.hjh.0000573252.02849.d1 ◽

2019 ◽

Vol 37 ◽

pp. e254-e255

Author(s):

H. Triantafyllidi ◽

A. Schoina ◽

D. Benas ◽

D. Birba ◽

D. Voutsinos ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Medical Treatment ◽

Blood Pressure Variability ◽

Treatment Initiation ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Damage Indices

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The Clinical Association of the Blood Pressure Variability with the Target Organ Damage in Hypertensive Patients with Chronic Kidney Disease

Journal of Korean Medical Science ◽

10.3346/jkms.2014.29.7.957 ◽

2014 ◽

Vol 29 (7) ◽

pp. 957 ◽

Cited By ~ 12

Author(s):

Jiwon Ryu ◽

Ran-hui Cha ◽

Dong Ki Kim ◽

Ju Hyun Lee ◽

Sun Ae Yoon ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Hypertensive Patients

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220 Relationship of blood pressure variability to left ventricular mass and micro-albuminuria as measures of target-organ damage

Journal of Hypertension ◽

10.1097/00004872-199312050-00389 ◽

1993 ◽

Vol 11 (5) ◽

pp. S494

Author(s):

Dirk P. Veerman ◽

K. de Blok ◽

B. L.M. Delemarre ◽

Gert A. van Montfrans

Keyword(s):

Blood Pressure ◽

Left Ventricular Mass ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Ventricular Mass ◽

Relationship Of

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Is there an association between blood pressure variability and target organ damage in diabetic and non-diabetic hypertensive patients?

American Journal of Hypertension ◽

10.1016/j.amjhyper.2004.03.334 ◽

2004 ◽

Vol 17 (5) ◽

pp. S127

Author(s):

P AMADO

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Hypertensive Patients

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IS THERE AN ASSOCIATION BETWEEN BLOOD PRESSURE VARIABILITY AND TARGET ORGAN DAMAGE IN DIABETIC AND NON-DIABETIC HYPERTENSIVE PATIENTS?

Journal of Hypertension ◽

10.1097/00004872-200406002-01285 ◽

2004 ◽

Vol 22 (Suppl. 2) ◽

pp. S367

Author(s):

J. Carmona ◽

P. Amado ◽

N. Vasconcelos ◽

J. Alves ◽

M. C. Rodrigues ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Hypertensive Patients

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P5470Studying target organ damage indices in newly diagnosed and never treated extreme dipper patients with essential hypertension

European Heart Journal ◽

10.1093/eurheartj/ehz746.0424 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Triantafyllidi ◽

A Schoinas ◽

D Benas ◽

M Varoudi ◽

D Birba ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Newly Diagnosed ◽

Night Time ◽

Hypertensive Patients ◽

Blood Pressure Decrease ◽

Damage Indices

Abstract Background Cardiovascular risk estimation in arterial hypertension includes the investigation for target organ damage indices (TOD). 24h ambulatory blood pressure monitoring (ABPM) represents the gold standard method for the confirmation of the arterial hypertension disease. Dipping phenomenon, defined as blood pressure decrease >10% during night-time measurements, leads to hypertension burden reduce during night and carries a positive prognostic significance. However, there are doubts regarding its prognosis when it becomes augmented (extreme dipping defined as blood pressure decrease >20% during night-time measurements). Aim of our study is to explore TOD existence between extreme dipper and dipper hypertensive patients with newly diagnosed and never treated arterial hypertension. Methods From the 480 total patients with newly diagnosed and never treated arterial hypertension who subjected to ABPM, we excluded 190 non-dipper patients and we divided the rest 290 hypertensives (mean age 49±11 years, 193 males) in normal dippers (n=245, mean age 49±11 years, 160 males) and extreme dippers (n=45, mean age 49±10 years, 33 males). Both groups were subjected to the following measurements: arterial stiffness (PWV), 24h microalbumin levels (MAU), carotid intima-media thickness (IMT), diastolic dysfunction (E/Ea), left ventricular mass index (LVMI) and coronary flow reserve (CFR). Results We did not find any differences within groups regarding age, sex distribution, BMI, office SBP/DBP, cenrtal SBP/DBP and daytime average SBP/DBP as well as PWV, MAU, IMT, E/Ea and CFR. We noticed that extreme dippers had reduced 24h average SBP/DBP (p=0.001 and p=0.02, respectively) and increased LVMI (86±18 vs. 79±20 gr/m2, p=0.04) compared to normal dippers. Differences in LVMI Conclusions Extreme dipper hypertensive patients have an increased LVMI, probably as a result of myocardial hypoxia due to severe blood pressure reduction over night. Our results point to the possible increased cardiovascular risk in this group of hypertensive patients.

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The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension

10.21203/rs.2.16969/v2 ◽

2020 ◽

Author(s):

Yang Liu ◽

Yao Lin ◽

Ming-Ming Zhang ◽

Tong Zheng ◽

Xiao-Hui Li ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Essential Hypertension ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Plasma Renin ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Renin Angiotensin

Abstract Background To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension. Methods A case-control study was conducted on 132 children diagnosed with essential hypertension(103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20． Results Among the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P= 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [ β± s.e.= 0.025±0.006, 95% CI ( 0.013–0.038), P = 0.0001] and aldosterone [ β± s.e.= 0.021±0.007, 95% CI( 0.008–0.034), P = 0.002] were risk factors for LVH. Conclusions The AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension.

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Uric Acid Is Not Associated With Blood Pressure Phenotypes and Target Organ Damage According to Blood Pressure Phenotypes

American Journal of Hypertension ◽

10.1093/ajh/hpaa130 ◽

2020 ◽

Author(s):

Anping Cai ◽

Lin Liu ◽

Mohammed Siddiqui ◽

Dan Zhou ◽

Jiyan Chen ◽

...

Keyword(s):

Blood Pressure ◽

Uric Acid ◽

Arterial Stiffness ◽

Blood Pressure Monitoring ◽

Target Organ Damage ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Uncontrolled Hypertension ◽

Hypertensive Patients

Abstract BACKGROUND Hypertensive patients with increased serum uric acid (SUA) are at increased cardiovascular (CV) risks. Both the European and American hypertension guidelines endorse the utilization of 24 h-ambulatory blood pressure monitoring (24 h-ABPM) for hypertensive patients with increased CV risk. While there is difference in identifying uric acid as a CV risk factor between the European and American guidelines. Therefore, it is unknown whether 24 h-ABPM should be used routinely in hypertensive patients with increased SUA. METHODS To address this knowledge gap, we investigated (i) the correlation between SUA and 24 h-ABP; (ii) the association between SUA and blood pressure (BP) phenotypes (controlled hypertension [CH], white-coat uncontrolled hypertension [WCUH], masked uncontrolled hypertension [MUCH], and sustained uncontrolled hypertension [SUCH]); (iii) the association between SUA and target organ damage (TOD: microalbuminuria, left ventricular hypertrophy [LVH], and arterial stiffness) according to BP phenotypes. RESULTS In 1,336 treated hypertensive patients (mean age 61.2 and female 55.4%), we found (i) there was no correlation between SUA and 24 h, daytime, and nighttime systolic blood pressure/diastolic blood pressure, respectively; (ii) in reference to CH, SUA increase was not associated WCUH (odds ratio [OR] 0.968, P = 0.609), MUCH (OR 1.026, P = 0.545), and SUCH (OR 1.003, P = 0.943); (iii) the overall prevalence of microalbuminuria, LVH, and arterial stiffness was 2.3%, 16.7%, and 23.2%, respectively. After adjustment for covariates, including age, sex, smoking, body mass index, diabetes mellitus, and estimated glomerular filtration rate, there was no association between SUA and TOD in all BP phenotypes. CONCLUSIONS These preliminary findings did not support routine use of 24 h-ABPM in treated hypertensive patients with increased SUA.

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