THE SIGNIFICANCE OF 24H BLOOD PRESSURE VARIABILITY DIFFERENCES 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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Correlation between blood pressure variability and subclinical target organ damage in patients with essential hypertension

Journal of Human Hypertension ◽

10.1038/s41371-019-0286-8 ◽

2019 ◽

Vol 34 (9) ◽

pp. 641-647 ◽

Cited By ~ 1

Author(s):

Mostafa El Mokadem ◽

Hesham Boshra ◽

Yasser Abd el Hady ◽

Amany Kasla ◽

Ahmed Gouda

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ

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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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Correlation among high salt intake, blood pressure variability, and target organ damage in patients with essential hypertension

Medicine ◽

10.1097/md.0000000000019548 ◽

2020 ◽

Vol 99 (14) ◽

pp. e19548

Author(s):

Wei Cai ◽

MingJian Lang ◽

XiaoBo Jiang ◽

Qian Yu ◽

Congliang Zhou ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Blood Pressure Variability ◽

Salt Intake ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

High Salt ◽

High Salt Intake

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Target organ damage and blood pressure variability in essential hypertension

American Journal of Hypertension ◽

10.1016/s0895-7061(01)01485-6 ◽

2001 ◽

Vol 14 (11) ◽

pp. A31

Author(s):

E Gomez-Angelats

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ

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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/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

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