Abstract 048: Systolic and Diastolic Ambulatory Blood Pressure Affect Target Organ Damage Differently in Adolescents: The SHIP AHOY Study

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Gilad Hamdani ◽  
Elaine M Urbina ◽  
Marc Lande ◽  
Kevin Meyers ◽  
Joshua Samuels ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Linear Models ◽  
Pulse Wave ◽  
Systolic Function ◽  
Target Organ Damage ◽  
Global Longitudinal Strain ◽  
Organ Damage ◽  
Target Organ ◽  
Weak Association ◽  
Increased Risk

Hypertensive target organ damage (TOD) is associated with increased risk for CV events. Ambulatory BP (ABP) measures are more strongly related to TOD than casual BP in adults but data in youth are lacking. Our objective was to determine which ABP parameters associated with TOD in adolescents. We evaluated casual BP (mean of 6 measures by auscultation), ABP (Spacelabs OnTrak), anthropometrics, labs, LVM, pulse wave velocity (PWV), diastolic function (E/E’ ratio), and systolic function (global longitudinal strain, GLS) in 132 adolescents (mean 15.8 + 1.4 yrs, 66% white, 57% male). Day, night and 24H SBP and DBP index (mean/95 th %ile for sex and height) and loads (%readings above the 95 th %ile) were defined according to sex and height-specific pediatric cut-points. General linear models were used to determine independent associations between ABP and TOD. Only systolic ABP means and loads were associated with LVMI and diastolic function, while both systolic and diastolic ABP means and loads were associated with PWV. There was a weak association between systolic and diastolic loads and GLS. In multiple regression analysis (full model: demographics, age, BMI, HR, ABP, metabolic profile, CRP) day SBP index was the strongest predictor of LVMI (β=15.2, R 2 0.4, p=0.006) and E/E’ (β=5.2, R 2 0.23, all p=0.007), while day DBP index was the strongest predictor of PWV (β=3.0, R 2 0.37, p<0.0001). Day DBP load was the sole independent ABP predictor of GLS (β=0.05, R 2 0.25, p=0.02). We conclude that during adolescence, systolic and diastolic ABP parameters are differentially associated with TOD: SBP predicted LVMI, while DBP predicted PWV. ABP parameters may be used to evaluate risk for BP-related TOD.

Abstract P182: Microangiopathic Complications In Malignant Hypertension: An Under-appreciated Form Of Target Organ Damage

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Akhil Jain ◽  
Bhumika Singhal ◽  
Rishabh Jindal ◽  
Chinmay Jani ◽  
Puneet K Gupta
Keyword(s):  
Target Organ Damage ◽  
Organ Damage ◽  
Pooled Analysis ◽  
Target Organ ◽  
Malignant Hypertension ◽  
Forest Plot ◽  
Significant Heterogeneity ◽  
Therapeutic Implications ◽  
Increased Risk ◽  
Hematological Changes

Fig 1: Summary of Malignant Hypertension Studies having Microangiopathic Complications along with Forest Plot Microangiopathic Complications in Malignant Hypertension: An underappreciated form of Target Organ Damage Background: Renal thrombotic microangiopathy is a clinically important complication of malignant hypertension (MHT), but its incidence in MHT has been sparsely studied. Our aim was to study the incidence of microangiopathic changes (MaC) in MHT. Methods: We searched Google Scholar database studies directly reporting MaC (mentioning either microangiopathic hemolytic anemia or thrombotic angiopathy) in presence of MHT. We used OpenMeta[Analyst] for the pooled analysis. Results: From 1967 to 2019, 9 studies were included. Maximum likelihood random-effects method showed pooled proportion estimate of having MaC in MHT to be 0.4 (95 CI: 0.3, 0.5; p<0.1). Significant heterogeneity with I 2 =82.56%, p <0.1 was found. Subgroup analysis showed pooled proportion of MaC in MHT to be 0.5 (95 CI: 0.4,0.7, p<0.1) for studies before 2000; whereas 0.2 (95 CI: 0.2, 0.3, p<0.1) for studies after 2000. Sex-wise distribution was reported in 7 studies, risk ratio of having MaC in MHT in female was found to be 1.24 compared to male. Conclusion: Our analysis suggests decreasing incidence of MaC in MHT over the past couple of decades and increased risk of this complication in females, although significant heterogeneity exists among studies reporting microangiopathic changes in malignant hypertension. More prospective observational studies are needed to better define the epidemiology of the hematological changes that occur in MHT since they have important therapeutic implications.

Abstract 545: Modification Over Time of Pulse Wave Velocity Parallel to Changes in Both Office and 24h-ambulatory Peripheral BP as well as Aortic BP

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Anna Oliveras ◽  
Julián Segura ◽  
Carmen Suárez ◽  
Luis García-Ortiz ◽  
María Abad ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Target Organ Damage ◽  
Measurement Techniques ◽  
Organ Damage ◽  
Applanation Tonometry ◽  
Target Organ ◽  
Over Time

Aim: to assess the relationship of changes in pulse wave velocity (PWV), a marker of target organ damage, with the variation in BP over time, as assessed by three different methods of measurement: office and 24h-ambulatory peripheral BP as well as aortic BP. Methods: Observational prospective study in hypertensive subjects with impaired glucose metabolism consecutively recruited from Spanish Hypertension Units. Aortic BP and carotid-femoral PWV were evaluated by radial applanation tonometry (Sphygmocor®) at baseline ( b ) and after 12 months of follow-up ( fu ). Peripheral BP measurements were also recorded at baseline and at 12 months follow-up: office BP was obtained as the average of triplicate measurements taken at 1 min-intervals after 5 min of seated rest, using validated oscillometric devices; 24h-ambulatory BP recordings were taken with a validated device (Spacelabs®-90207) at 20-minute intervals throughout both the self-reported awake and asleep periods. Clinical and anthropometric features were also recorded. PWV variation (Δ) over time was calculated as follows: Δ PWV= [(PWV fu - PWV b ) / PWV b ] x 100. BP variation over time was calculated with the same formula applied to BP values obtained with the different measurement techniques. Correlations (Spearman “Rho”) of Δ PWV and Δ BP were calculated. Results: n=209 patients; mean age: 61.8 ± 11.2 y; 39% (81 of 209) were female; 80% (167 of 209) had type 2 diabetes. Other risk factors: hypertension: 100%; dyslipidemia: 69% (144 of 209); smokers: 13% (28 of 209); body mass index: 30.9 ± 4.4 Kg/m 2 . Baseline office systolic/diastolic BP (mmHg): oSBP = 143 ± 20; oDBP = 82 ± 12. Follow-up office systolic/diastolic BP (mmHg): oSBP = 136 ± 20; oDBP = 79 ± 12. Baseline PWV: 10.01 ± 3.5 m/s. Follow-up PWV: 10.19 ± 3.21 m/s. Δ PWV correlated with: Δ oSBP (Rho=0.212; p=0.002), Δ 24h-SBP (Rho=0.254; p<0.001), Δ daytime-BP (Rho=0.232; p=0.001), Δ nighttime-BP (Rho=0.320; p<0.001) and Δ aortic-SBP (Rho=0.320; p<0.001). Conclusion: Modification over time of PWV, a marker of target organ damage, parallel to changes in systolic BP, both office and 24h-ambulatory peripheral BP variation as well as aortic BP variation, at 12 months of follow-up. Among them, aortic SBP and nighttime peripheral SBP both showed the best correlation.

P3833Low heart rate variability is associated with future arrhythmic events in hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Terentes-Printzios ◽  
C Vlachopoulos ◽  
L Korogiannis ◽  
G Christopoulou ◽  
P Xydis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Primary Endpoint ◽  
Target Organ Damage ◽  
Roc Curves ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Increased Risk

Abstract Background/Introduction Cardiac autonomic dysfunction and target organ damage are associated with increased cardiovascular mortality and arrhythmias. Purpose The aim of the study was to investigate the effect of heart rate variability (HRV) and markers of target organ damage in the prognosis of future arrhythmic events. Methods We studied 292 untreated at baseline hypertensives (mean age 53±13, 153 males). Cardiac autonomic function was evaluated by analysis of short-term HRV measures over 24-h using 24-h ambulatory blood pressure monitoring and the standard deviation of the measurements. Echocardiography was also performed and left ventricular mass index (LVMI) was estimated with the Demereux formula. Aortic stiffness was assessed with carotid-femoral pulse wave velocity (cfPWV) and wave reflections with aortic augmentation index corrected for heart rate (Alx@75). Patients were followed up for a median period of 13 years. The primary endpoint was a composite of atrial/ventricular tachycardias, symptomatic multiple premature ventricular contractions, second and third-degree heart blocks and pacemaker/defibrillator placement. Results In comparison without events, patients with the primary endpoint (n=37, 13%) had lower 24-h daytime HRV (9.6 beats per minute vs. 11.1 beats per minute, p=0.005), higher systolic blood pressure (168 mmHg vs. 163 mmHg, p=0.003), higher cfPWV (8.4 m/s vs. 7.7 m/s, p=0.005), higher LVMI (133 g/m2 vs. 122 g/m2, p=0.002) and higher AIx@75 (29.0% vs. 26.3%, p=0.043). In further analysis, receiver operating characteristic (ROC) curves were generated to evaluate the ability of HRV, cfPWV, LVMI and AIx@75 to discriminate subjects with arrhythmic events. The area under the curve (AUC) and 95% CIs of the ROC curves were AUC=0.35 (95% CI: 0.26–0.44, p=0.003) for HRV, AUC=0.64 (95% CI: 0.54–0.73, P<0.006) for cfPWV, AUC=0.67 (95% CI: 0.58–0.75, P=0.001) for LVMI and AUC=0.55 (95% CI: 0.47–0.64, P=0.298) for AIx@75 (Figure). In Cox regression analysis, only HRV was associated with increased risk of arrhythmic events (Hazard ratio per 1 unit =0.87, 95% Confidence intervals 0.76 to 0.995, p=0.043) when adjusted for age, gender, cfPWV, LVMI and AIx@75. ROC curves of HRV & target organ damage Conclusions Low heart rate variability is associated with increased risk of future arrhythmic events suggesting an early sympathovagal imbalance that could lead to future events in hypertension.

P60 PSYCHOLOGICAL DETERMINANTS OF TARGET ORGAN DAMAGE IN HYPERTENSIVE PATIENTS: FOCUS ON PULSE WAVE VELOCITY AND DEPRESSION

2017 ◽  
Vol 20 (C) ◽  
pp. 70
Author(s):  
Andrea Greco ◽  
Alessandro Maloberti ◽  
Marisa Varrenti ◽  
Ilaria Bassi ◽  
Enrico Piccinelli ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Hypertensive Patients ◽  
Psychological Determinants

Premenopausal Women Have Increased Risk of Hypertensive Target Organ Damage Compared with Men of Similar Age

2011 ◽  
Vol 20 (8) ◽  
pp. 1175-1181 ◽  
Author(s):  
Paolo Palatini ◽  
Lucio Mos ◽  
Massimo Santonastaso ◽  
Francesca Saladini ◽  
Elisabetta Benetti ◽  
...  
Keyword(s):  
Target Organ Damage ◽  
Premenopausal Women ◽  
Organ Damage ◽  
Target Organ ◽  
Increased Risk

scholarly journals Impact of Uric Acid on Hypertension Occurrence and Target Organ Damage: Insights From the STANISLAS Cohort With a 20-Year Follow-up

2020 ◽  
Vol 33 (9) ◽  
pp. 869-878 ◽  
Author(s):  
Mehmet Kanbay ◽  
Nicolas Girerd ◽  
Jean-Loup Machu ◽  
Erwan Bozec ◽  
Kevin Duarte ◽  
...  
Keyword(s):  
Uric Acid ◽  
Diastolic Dysfunction ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Urine Albumin ◽  
Increased Risk ◽  
Older Subjects

Abstract BACKGROUND Recent studies have shown that hyperuricemia may be associated with incident hypertension (HTN). We examined whether serum uric acid (SUA) is a predictor of HTN and target organ damage (TOD) 20 years later in initially healthy middle-aged individuals. METHODS Participants from the Suivi Temporaire Annuel Non-Invasif de la Santé des Lorrains Assurés Sociaux (STANISLAS) a single-center familial longitudinal cohort study (961 initially healthy adults and 570 children) underwent clinical and laboratory measurements at baseline and after approximately 20 years. Blood pressure (BP: using ambulatory BP measurements), urine albumin-to-creatinine ratio, estimated glomerular filtration rate (eGFR), left ventricular hypertrophy (LVH), diastolic dysfunction, and carotid–femoral pulse wave velocity (PWV) were measured at the end of follow-up. RESULTS In the parent population, higher baseline or last SUA levels and higher change in SUA (ΔUA) were significantly associated with an increased risk of HTN development, even after adjusting for known HTN risk factors (all P &lt; 0.01). Higher baseline SUA was marginally associated with an increased risk of having high carotid–femoral PWV (P = 0.05). The association of SUA with BP increase was body mass index dependent (the increase in BP being greater in leaner subjects; interactionp &lt; 0.05), and the association of SUA with eGFR decline was age dependent (the decline in eGFR being greater in older subjects; interactionp &lt; 0.05). There was no significant association between SUA and diastolic dysfunction or LVH. In the whole population (i.e. including children), a significant association between SUA at baseline and the risk of HTN and higher carotid–femoral PWV was also found (both P &lt; 0.02). CONCLUSIONS Increased SUA is associated with the development of HTN and vascular/renal TOD in initially healthy midlife subjects.

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