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

The overall goal of this study was to determine race/ethnic differences in the associations between renal ET-1 and indices of blood pressure-related target organ damage in healthy adolescents. The subjects ranged in age between 15-19 years, had no history of any disease, and were not on any prescription medications. The 92 subjects consisted of 48 Caucasians (CA) and 44 African-Americans (AA). The two groups were similar with respect to height, weight, body mass index, blood pressure, ET-1), albumin excretion rate (AER), and left ventricular mass). Results: The CA’s were slightly older 17±1 v 16±1 (p=.02). The protocol was preceded by a 3 day self-selected sodium controlled diet of 250 mEq/day day which the subject picked up each day. The test day began with an echocardiogram for the assessment of left ventricular mass. Next, the subjects were seated for 60 minutes of rest during which the subjects consumed 200 ml of water. This was followed by the collection of a urine sample for the measurement of ET-1 and AER. Overall, ET-1 excretion was correlated with AER (r=.278), LV mass/ht 2.7 (r=.341), and systolic blood pressure (SBP; r=.365; p=.01 for each). The significant overall correlations were the result of significant correlations in AAs for AER (r=.344; p=.05), LV mass/ht 2.7 (r=.520; p=.01), and SBP (r=.645; p=.01) which were not apparent in CA’s. These findings suggest urinary ET-1 contributes to the development of BP-related target organ damage in AA youths prior to the development of increases in blood pressure.

Download Full-text

P9.6 BLOOD PRESSURE VARIABILITY AND TARGET ORGAN DAMAGE IN PATIENTS WITH UNCOMPLICATED HYPERTENSION: AVERAGE 24 HOUR AMBULATORY BLOOD PRESSURE IS MORE RELEVANT TO CHANGES IN LEFT VENTRICULAR MASS INDEX

Artery Research ◽

10.1016/j.artres.2014.09.194 ◽

2014 ◽

Vol 8 (4) ◽

pp. 155

Author(s):

P. Veloudi ◽

L. Blizzard ◽

J. Sharman

Keyword(s):

Blood Pressure ◽

Left Ventricular Mass ◽

Ambulatory Blood Pressure ◽

Blood Pressure Variability ◽

Left Ventricular Mass Index ◽

Target Organ Damage ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Uncomplicated Hypertension

Download Full-text

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

European Heart Journal ◽

10.1093/eurheartj/ehz747.0403 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Triantafyllidi ◽

A Schoinas ◽

D Benas ◽

D Birba ◽

D Voutsinos ◽

...

Keyword(s):

Blood Pressure ◽

Medical Treatment ◽

Blood Pressure Variability ◽

Treatment Initiation ◽

Target Organ Damage ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Hypertensive Patients ◽

Damage Indices

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.

Download Full-text

Marinobufagenin and left ventricular mass in young adults: The African-PREDICT study

European Journal of Preventive Cardiology ◽

10.1177/2047487318788140 ◽

2018 ◽

Vol 25 (15) ◽

pp. 1587-1595 ◽

Cited By ~ 10

Author(s):

Michél Strauss ◽

Wayne Smith ◽

Ruan Kruger ◽

Wen Wei ◽

Olga V Fedorova ◽

...

Keyword(s):

Young Adults ◽

Stroke Volume ◽

Left Ventricular Mass ◽

Target Organ Damage ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

End Diastolic Volume ◽

Ventricular Mass ◽

Predict Study

Background The endogenous steroidal inhibitor of sodium–potassium-dependent adenosine triphosphate and natriuretic hormone, marinobufagenin, plays a physiological role in ionic homeostasis. Animal models suggest that elevated marinobufagenin adversely associates with cardiac and renal, structural and functional alterations. It remains uncertain whether marinobufagenin relates to the early stages of target organ damage development, especially in young adults without cardiovascular disease. We therefore explored whether elevated 24-hour urinary marinobufagenin excretion was related to indices of subclinical target organ damage in young healthy adults. Design This cross-sectional study included 711 participants from the African-PREDICT study (black 51%, men 42%, 24.8 ± 3.02 years). Methods We assessed cardiac geometry and function by two-dimensional echocardiography and pulse wave Doppler imaging. 24-Hour urinary marinobufagenin and sodium excretion were measured, and the estimated glomerular filtration rate determined. Results Across marinobufagenin excretion quartiles, left ventricular mass ( P < 0.001), end diastolic volume ( P < 0.001), stroke volume ( P = 0.004) and sodium excretion ( P < 0.001) were higher within the fourth compared with the first quartile. Partial regression analyses indicated that left ventricular mass ( r = 0.08, P = 0.043), end diastolic volume ( r = 0.10, P = 0.010) and stroke volume ( r = 0.09, P = 0.022) were positively related to marinobufagenin excretion. In multivariate-adjusted regression analysis, left ventricular mass associated positively with marinobufagenin excretion only in the highest marinobufagenin excretion quartile (adjusted R2 = 0.20; β = 0.15; P = 0.043). This relationship between left ventricular mass and marinobufagenin excretion was evident in women (adjusted R2 = 0.06; β = 0.127; P = 0.015) but not in men (adjusted R2 = 0.06; β = 0.007; P = 0.92). Conclusions Left ventricular mass positively and independently associates with marinobufagenin excretion in young healthy adults with excessively high marinobufagenin excretion. Women may be more sensitive to the effects of marinobufagenin on early structural cardiac changes.

Download Full-text

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.

Download Full-text

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/v3 ◽

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. Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system

Download Full-text

VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND TARGET ORGAN DAMAGE IN RURAL DWELLERS WITH UNCOMPLICATED ARTERIAL HYPERTENSION

Wiadomości Lekarskie ◽

10.36740/wlek202012107 ◽

2020 ◽

Vol 73 (12) ◽

pp. 2591-2597

Author(s):

Tetiana I. Nimtsovych ◽

Anatolii M. Kravchenko ◽

Olha Yu. Mishcheniuk ◽

Tamara Ya. Chursina ◽

Кyrylo О. Mikhaliev ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Clinical Aspects ◽

High Risk Population ◽

Uncomplicated Hypertension ◽

Rural Dwellers

The aim: To examine the association of hypertensive mediated target organ damage with blood pressure visit-to-visit variability in Ukrainian rural dwellers with uncomplicated hypertension. Material and methods: The cross-sectional study enrolled 160 adult males with uncomplicated primary hypertension (mean age 50±6 yo). We analyzed office systolic and diastolic blood pressure levels, obtained at four consecutive visits. We used standard deviation (SD) value to assess blood pressure visit-to-visit variability. The patients were referred to the group with high (n=82; 51.3%) vs low (n=78; 48.7%) blood pressure variability (HBPV, LBPV). Results: HBPV patients were characterized by higher left ventricular myocardial mass indexed to height 2.7: median, interquartile range: 70.9 (61.3-78.2) vs 50.9 (44.9-54.4) g/m2.7, respectively p<0.001. The cases of severe left ventricular hypertrophy prevailed in HBPV group (vs LBPV): 68% vs 5%, respectively, p<0.001. HBPV group was characterized by larger common carotid artery intima-media complex thickness, advanced hypertensive retinopathy, higher urine albumin/creatinine ratio value and worse kidneys’ glomerular filtration rate. The obtained results might be helpful in the context of global monitoring of vulnerable high risk population of hypertensive rural males. Conclusions: The HBPV in rural hypertensive males was associated with more pronounced target organ damage. Further regional research on the various clinical aspects of hypertension, including blood pressure variability, might be useful in extending the existed evidence on prevention of hypertension-related complications.

Download Full-text