scholarly journals Cross-sectional association of blood pressure variability and night-time dipping with cardiac structure in adolescents

2020 ◽  
Author(s):  
LJ Goudswaard ◽  
S Harrison ◽  
D Van De Klee ◽  
N Chaturvedi ◽  
DA Lawlor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Variability ◽  
Left Ventricular ◽  
Internal Diameter ◽  
Cardiac Structure ◽  
Night Time ◽  
Cross Sectional ◽  
The Mean ◽  
Average Real Variability ◽  
Sectional Analysis

AbstractGreater blood pressure variability (BP) and reduced night-time BP dipping are associated with cardiovascular disease independently of mean BP in adults. This study examines whether these associations are apparent in adolescents. A cross-sectional analysis was undertaken in 587 UK adolescents. We examined associations between measures of blood pressure dipping and variability (including standard deviation weighted for day/night (SDdn), average real variability (ARV) and variability independent of the mean (VIM)) with cardiac structure measures assessed by echocardiography: (1) left ventricular mass indexed to height2.7 (LVMi2.7), (2) relative wall thickness (RWT), (3) left atrial diameter indexed to height (LADi), and (4) left ventricular internal diameter in diastole (LVIDD)). Greater BP variability was associated with cardiac structures including higher RWT, which persisted after adjustment for mean BP. There was no evidence for an association between night-time dipping and cardiac structures. Measurement of BP variability might benefit cardiovascular risk assessment in adolescents.

scholarly journals Blood pressure variability and night-time dipping assessed by 24-hour ambulatory monitoring: Cross-sectional association with cardiac structure in adolescents

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253196
Author(s):  
Lucy J. Goudswaard ◽  
Sean Harrison ◽  
Daniel Van De Klee ◽  
Nishi Chaturvedi ◽  
Debbie A. Lawlor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Monitoring ◽  
Left Ventricular ◽  
Internal Diameter ◽  
Cardiac Structure ◽  
Night Time ◽  
Cross Sectional ◽  
Average Real Variability ◽  
Sectional Analysis ◽  
Structure Measurement

Greater blood pressure (BP) is associated with greater left ventricular mass indexed to height2.7 (LVMi2.7) in adolescents. This study examined whether greater BP variability and reduced night-time dipping are associated with cardiac remodeling in a general population of adolescents. A cross-sectional analysis was undertaken in 587 UK adolescents (mean age 17.7 years; 43.1% male). BP was measured in a research clinic and using 24-hour ambulatory monitoring. We examined associations (for both systolic and diastolic BP) of: 1) clinic and 24-hour mean BP; 2) measures of 24-hour BP variability: standard deviation weighted for day/night (SDdn), variability independent of the mean (VIM) and average real variability (ARV); and 3) night-time dipping with cardiac structures. Cardiac structures were assessed by echocardiography: 1) LVMi2.7; 2) relative wall thickness (RWT); 3) left atrial diameter indexed to height (LADi) and 4) left ventricular internal diameter in diastole (LVIDD). Higher systolic BP was associated with greater LVMi2.7. Systolic and diastolic BP were associated with greater RWT. Associations were inconsistent for LADi and LVIDD. There was evidence for associations between both greater SDdn and ARV and higher RWT (per 1 SD higher diastolic ARV, mean difference in RWT was 0.13 SDs, 95% CI 0.045 to 0.21); these associations with RWT remained after adjustment for mean BP. There was no consistent evidence of associations between night-time dipping and cardiac structure. Measurement of BP variability, even in adolescents with blood pressure in the physiologic range, might benefit risk of cardiovascular remodeling assessment.

Mechanisms of blood pressure variability-induced cardiac hypertrophy and dysfunction in mice with impaired baroreflex

2005 ◽  
Vol 288 (3) ◽  
pp. R767-R776 ◽  
Author(s):  
Peter Martinka ◽  
Jens Fielitz ◽  
Andreas Patzak ◽  
Vera Regitz-Zagrosek ◽  
Pontus B. Persson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Hypertrophy ◽  
Protein Content ◽  
High Blood Pressure ◽  
Blood Pressure Variability ◽  
Transforming Growth Factor ◽  
Renin Angiotensin System ◽  
Left Ventricular ◽  
Mitogen Activated Protein Kinase ◽  
Cross Sectional

Enhanced blood pressure variability contributes to left ventricular hypertrophy and end-organ damage, even in the absence of hypertension. We hypothesized that the greater number of high-blood pressure episodes associated with enhanced blood pressure variability causes cardiac hypertrophy and dysfunction by activation of mechanosensitive and autocrine pathways. Normotensive mice were subjected to sinoaortic baroreceptor denervation (SAD) or sham surgery. Twelve weeks later, blood pressure variability was doubled in SAD compared with sham-operated mice. Blood pressure did not differ. Cardiac hypertrophy was reflected in greater heart/body weight ratios, larger myocyte cross-sectional areas, and greater left ventricular collagen deposition. Furthermore, left ventricular atrial and brain natriuretic peptide mRNA expression was greater in SAD than in sham-operated mice. SAD had higher left ventricular end-diastolic pressures and lower myocardial contractility indexes, indicating cardiac dysfunction. Cardiac protein content of phosphorylated p125 focal adhesion kinase (p125 FAK) and phosphorylated p38 mitogen-activated protein kinase (p38 MAPK) was greater in SAD than in sham-operated mice, indicating activation of mechanosensitive pathways of cardiac hypertrophy. Furthermore, enhanced cardiac renin and transforming growth factor-β1 (TGFbeta1) protein content indicates activation of autocrine pathways of cardiac hypertrophy. Adrenal tyrosine hydroxylase protein content and the number of renin-positive glomeruli were not different, suggesting that sympathetic activation and the systemic renin-angiotensin system did not contribute to cardiac hypertrophy. In conclusion, more frequent blood pressure rises in subjects with high blood pressure variability activate mechanosensitive and autocrine pathways leading to cardiac hypertrophy and dysfunction even in the absence of hypertension.

scholarly journals Sociodemographic patterns of urine sodium excretion and its association with hypertension in Chile: a cross-sectional analysis

2019 ◽  
Vol 22 (11) ◽  
pp. 2012-2021 ◽  
Author(s):  
Fanny Petermann-Rocha ◽  
Anne Sillars ◽  
Rosemary Brown ◽  
Lauren Sweeney ◽  
Claudia Troncoso ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Urine Analysis ◽  
National Health Survey ◽  
Dietary Salt ◽  
Cross Sectional ◽  
Policy Makers ◽  
Trained Staff ◽  
The Mean ◽  
Sectional Analysis ◽  
Public Health Strategies

AbstractObjectiveThe aim of the study was to determine the main factors (sociodemographic, anthropometric, lifestyle and health status) associated with high Na excretion in a representative population of Chile.DesignNa excretion (g/d), a valid marker of Na intake, was determined by urine analysis and Tanaka’s formulas. Blood pressure was measured by trained staff and derived from the mean of three readings recorded after 15 min rest. The associations of Na excretion with blood pressure and the primary correlates of high Na excretion were determined using logistic regression.SettingChileans aged ≥15 years.ParticipantsParticipants (n 2913) from the Chilean National Health Survey 2009–2010.ResultsIndividuals aged 25 years or over, those who were obese and those who had hypertension, diabetes or metabolic syndrome were more likely to have higher Na excretion. The odds for hypertension increased by 10·2 % per 0·4 g/d increment in Na excretion (OR=1·10; 95 % CI 1·06, 1·14; P < 0·0001). These findings were independent of major confounding factors.ConclusionsAge, sex, adiposity, sitting behaviours and existing co-morbidities such as diabetes were associated with higher Na excretion levels in the Chilean population. These findings could help policy makers to implement public health strategies tailored towards individuals who are more likely to consume high levels of dietary salt.

scholarly journals Prognostic Value of Ambulatory Blood Pressure Load in Pediatric CKD

2020 ◽  
Vol 15 (4) ◽  
pp. 493-500
Author(s):  
Jason Lee ◽  
Charles E. McCulloch ◽  
Joseph T. Flynn ◽  
Joshua Samuels ◽  
Bradley A. Warady ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cross Section ◽  
Odds Ratio ◽  
Prognostic Value ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Pediatric Ckd ◽  
Sectional Analysis

Background and objectivesElevated BP load is part of the criteria for ambulatory hypertension in pediatric but not adult guidelines. Our objectives were to determine the prevalence of isolated BP load elevation and associated risk with adverse outcomes in children with CKD, and to ascertain whether BP load offers risk discrimination independently or in conjunction with mean ambulatory BPs.Design, setting, participants, & measurementsWe studied 533 children in the CKD in Children (CKiD) Study to determine the prevalence of normotension, isolated BP load elevation (≥25% of all readings elevated but mean BP normal), and ambulatory hypertension. We examined the association between these categories of BP control and adverse outcomes (left ventricular hypertrophy [LVH] or ESKD). We used c-statistics to determine risk discrimination for outcomes by BP load used either independently or in conjunction with other BP parameters.ResultsOverall, 23% of the cohort had isolated BP load elevation, but isolated BP load elevation was not statistically significantly associated with LVH in cross-section (odds ratio, 1.8; 95% CI, 0.8 to 4.2) or time to ESKD (hazard ratio, 1.2; 95% CI, 0.7 to 2.0). In unadjusted cross-sectional analysis, every 10% higher systolic BP load was associated with 1.1-times higher odds of LVH (95% CI, 1.0 to 1.3), but discrimination for LVH was poor (c=0.61). In unadjusted longitudinal analysis, every 10% higher systolic BP load was associated with a 1.2-times higher risk of ESKD (95% CI, 1.1 to 1.2), but discrimination for ESKD was also poor (c=0.60). After accounting for mean systolic BP, systolic BP load was not statistically significantly associated with either LVH or ESKD. Findings were similar with diastolic BP load.ConclusionsBP load does not provide additive value in discriminating outcomes when used independently or in conjunction with mean systolic BP in children with CKD.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_03_11_CPOD10130819.mp3

scholarly journals Analysis of Short-term Blood Pressure Variability in Pheochromocytoma/Paraganglioma Patients

Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 658 ◽  
Author(s):  
Valeria Bisogni ◽  
Luigi Petramala ◽  
Gaia Oliviero ◽  
Maria Bonvicini ◽  
Martina Mezzadri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Variability ◽  
Blood Pressure Monitoring ◽  
Proper Treatment ◽  
Pressure Monitoring ◽  
Short Term ◽  
Night Time ◽  
Before And After ◽  
Average Real Variability ◽  
Urinary Metanephrines

Data on short-term blood pressure variability (BPV), which is a well-established cardiovascular prognostic tool, in pheochromocytoma and paraganglioma (PPGL) patients is still lack and conflicting. We retrospectively evaluated 23 PPGL patients referred to our unit from 2010 to 2019 to analyze 24 h ambulatory blood pressure monitoring (24-h ABPM)-derived markers of short-term BPV, before and after surgical treatment. PPGL diagnosis was assessed according to guidelines and confirmed by histologic examination. The 24-h ABPM-derived markers of short-term BPV included: circadian pressure rhythm; standard deviation (SD) and weighted SD (wSD) of 24-h, daytime, and night-time systolic and diastolic blood pressure (BP); average real variability (ARV) of 24-h, daytime, and night-time systolic and diastolic BP. 7 males and 16 females of 53 ± 18 years old were evaluated. After surgical resection of PPGL we found a significant decrease in 24-h systolic BP ARV (8.8 ± 1.6 vs. 7.6 ± 1.3 mmHg, p < 0.001), in 24-h diastolic BP ARV (7.5 ± 1.6 vs. 6.9 ± 1.4 mmHg, p = 0.031), and in wSD of 24-h diastolic BP (9.7 ± 2.0 vs 8.8 ± 2.1 mmHg, p = 0.050) comparing to baseline measurements. Moreover, baseline 24-h urinary metanephrines significantly correlated with wSD of both 24-h systolic and diastolic BP. Our study highlights as PPGL patients, after proper treatment, show a significant decrease in some short-term BPV markers, which might represent a further cardiovascular risk factor.

P0156SHORT-TERM BLOOD PRESSURE VARIABILITY IN DIABETIC AND NON-DIABETIC PATIENTS WITH CKD STAGE 2, 3A, 3B AND 4

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Maria Schoina ◽  
Charalampos Loutradis ◽  
Ioanna Minopoulou ◽  
Marieta Theodorakopoulou ◽  
Theodoros Dimitroulas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Blood Pressure Variability ◽  
Diabetic Patients ◽  
Additional Risk Factor ◽  
Night Time ◽  
Stage 4 ◽  
Ckd Stage ◽  
Average Real Variability

Abstract Background and Aims Blood pressure variability (BPV) is an important risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). Previous evidence suggests that BPV is gradually increasing across CKD stages. Whether type 2 diabetes mellitus (DM) is an additional risk factor for increased BPV has never been studied. The aim of this study is to examine in comparison BPV in diabetic and non-diabetic patients with CKD. Method We included 48 diabetic and 48 non-diabetic adult patients (&gt;18 years) with CKD (eGFR: &lt;90 και ≥15mL/min/1.73m2), matched in a 1:1 ratio for age, sex and eGFR within each CKD stage (2, 3a, 3b and 4). All patients underwent 24-hour ambulatory blood pressure (BP) measurement with the Mobil-O-Graph device. Brachial BP variability was calculated with validated formulas. We calculated standard deviation (SD), weighted SD (wSD), coefficient of variation (CV), and average real variability (ARV) of BP during the 24-hour, day- and night-time periods with validated formulas. Results In total population, ambulatory systolic BP (SBP) levels were significantly higher in diabetics compared to non-diabetic counterparts in all studied periods. No significant differences were evidence for ambulatory diastolic BP (DBP) in total or across CKD stages. In total, 24-hour SBP SD (15.43±4.34 vs 13.38±3.35, p=0.011), wSD (14.41±4.11 vs 12.53±3.19, p=0.014) and ARV (10.94±2.75 vs 9.46±2.10, p=0.004) were higher in patients with DM compared to those without DM. In addition, 24hour DBP SD (11.04±2.39 vs 9.80±2.28, p=0.010), wSD (10.30±2.52vs 9.05±1.99, p=0.008), CV (14.77±3.05 vs 13.14±2.96, p=0.009) and ARV (8.23±2.10 vs 7.10±1.33, p=0.002) were again different between groups. Across CKD stages 2 and 3a, BPV indices were insignificantly higher in patients with DM. In CKD Stage 3b, 24-hour SBP-SD (16.30±4.52 vs 11.35±2.62, p=0.003), wSD (15.42±4.54 vs 10.77±2.30, p=0.004), ARV (12.46±3.19 vs 8.34±2.07, p=0.001) and 24-hour DBP-CV (14.84±3.63 vs 12.18±1.91, p=0.035) were higher in diabetic compared to non-diabetic patients. In contrast, no difference between groups existed in CKD Stage 4. Conclusion Patients with DM present increased BPV in CKD Stages 2, 3a and 3b (moderately impaired renal function). This difference is not apparent in patients with advanced CKD at Stage 4.

Long term habitual vigorous physical activity is associated with lower visit-to-visit systolic blood pressure variability

2020 ◽  
Author(s):  
Xiaoyong Xu ◽  
Xianghong Meng ◽  
Shin-ichi Oka
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Vigorous Physical Activity ◽  
Systolic Blood Pressure Variability ◽  
Average Real Variability ◽  
Post Hoc

Abstract Objective Our work aimed to investigate the association between vigorous physical activity and visit-to-visit systolic blood pressure variability (BPV). Methods We conducted a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a well-characterized cohort of participants randomized to intensive (&lt;120 mmHg) or standard (&lt;140 mmHg) SBP targets. We assessed whether patients with hypertension who habitually engage in vigorous physical activity would have lower visit-to-visit systolic BPV compared with those who do not engage in vigorous physical activity. Visit-to-visit systolic BPV was calculated by standard deviation (SD), average real variability (ARV), and standard deviation independent of the mean (SDIM) using measurements taken during the 1-, 2-, 3-, 6-, 9- and 12-month study visits. A medical history questionnaire assessed vigorous physical activity, which was divided into three categories according to the frequency of vigorous physical activity. Results A total of 7571 participants were eligible for analysis (34.8% female, mean age 67.9±9.3 years). During a follow-up of 1-year, vigorous physical activity could significantly reduce SD, ARV, and SDIM across increasing frequency of vigorous physical activity. There were negative linear trends between frequency of vigorous physical activity and visit-to-visit systolic BPV. Conclusions Long-term engagement in vigorous physical activity was associated with lower visit-to-visit systolic BPV.

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