Abstract P119: Cardiovascular Risk And Subclinical Target Organ Damage In A Young Adult Population Provided By A Primary Healthcare Center In Brazil (Laparc Study)

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Beatriz Deberaldini Marinho ◽  
Deisianny Santos ◽  
Rodrigo Borges ◽  
Tomás de Souza Mello ◽  
Natalia Ushijima ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Healthcare ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Neck Circumference ◽  
Target Organ ◽  
Healthy Population ◽  
Masked Hypertension ◽  
Healthcare Center ◽  
Primary Healthcare Center

Background: In this young and apparently healthy population, it is important to identify early CV risk factors and subclinical target organ damage (TOD) with low complexity procedures, aiming regression, control and primary prevention with future reduction of CV morbidity and mortality. Objectives: To evaluate subclinical TOD using Ankle-Brachial Index (ABI), Office and Home Pulse Pressure (PP), identifying arterial stiffness. Methods: A cross-sectional population study for CV risk assessment in adults aged 20-50 years old provided by a Primary Healthcare Center in Brazil. A total of 632 individuals were evaluated (40% male; mean age 36 ± 9 years). Socio-demographic, anthropometric data, and lifestyle evaluation were recorded. All underwent Office Blood Pressure (OBP) measurements in the 4 limbs to calculate the ABI and office PP. All received the Home Blood Pressure Monitoring (HBPM) device (7 days protocol) and the mean of the general BP and the calculation of the PP were evaluated. They also performed an ECG to calculate Sokolow-Lyon Index (SLI) and Cornell Voltage Index (CVI). Results: The prevalence of hypertension according to OBP was 16% and 18% according to HBPM, but with a low agreement between diagnoses (kappa = 0.385). HBPM identified 4 phenotypes: normotension (74%), sustained hypertension (8%), masked hypertension (10%), and white coat hypertension (8%). The median of office PP was 46 [39-52] mmHg and of Home PP was 45 [41-50] mmHg. Elevated Office PP and Home PP (> 60 mmHg) were identified in 64 and 28 participants, respectively. High office PP was more frequent in men, obese, with increased neck circumference and lower ABI. It was also associated with higher SLI and CVI. High Home PP was also more frequent in men, obese, with increased neck circumference and higher CVI. The median of the ABI was 1.14 [1.08-1.22], which is the cutoff point we used to define early changes in the ABI. Individuals with decreased ABI are more obese, with smaller neck circumference and lower OBP control. They also had higher systolic BP values and office PP (49 vs 43 mmHg, p<0.001). Conclusion: In this young population, early changes in subclinical TOD already identify a higher CV risk profile, indicating the importance of implementing prevention measures to reduce this risk.

scholarly journals Phenotyping of masked hypertension based on the clustering of 24-hour blood pressure monitoring data

2020 ◽  
Vol 25 (3) ◽  
pp. 3286
Author(s):  
B. I. Geltser ◽  
K. I. Shakhgeldyan ◽  
V. N. Kotelnikov ◽  
O. O. Vetrova ◽  
V. V. Orlova-Ilyinskaya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Masked Hypertension ◽  
Pressure Monitoring ◽  
Balanced Distribution ◽  
R Programming ◽  
Glomerular Filtration Rate Estimation

Aim. Phenotyping of masked hypertension (MH) based on clustering of 24-hour ambulatory blood pressure monitoring (ABPM) results data and comparing it with indicators of target organ damage.Material and methods. We retrospectively analyzed medical records of 207 men with a median age of 34,6 years and normal office blood pressure (BP), who were systematically exposed to occupational stressors and were undergoing a routine in-patient examination. All patients underwent ABPM, echocardiography, carotid ultrasound, glomerular filtration rate estimation. The clustering of ABPM data was carried out using the Kohonen self-organizing neural networks and K-means algorithm. Data processing was performed in the R programming language using the RStudio environment.Results. MH was diagnosed in 142 (68,6%) patients which were divided into 3 clusters according to 4 criteria factors of ABPM: systolic-diastolic (SDMH) — 50,7%, isolated systolic (ISMH) — 27,5% and isolated diastolic (IDMH) — 21,8%. Majority (51,4%) of patients with SDMH were characterized by a relatively balanced distribution of episodes of increased systolic and diastolic BP during the day, and other ratios were much less common. In patients with ISMH, hypertension prevailed in the daylight, and in IDMР — nighttime. Individual clusters differed significantly in terms of the 24-hour BP profile and signs of target organ damage. Various types of cardiac remodeling were recorded in 24 (17%) patients with MH, 16 (66,7%) of which belonged to the SDMH phenotype. Intima-media thickening >0,9 mm occurred in 40% of patients with IDMH, in 30% — SDMH and only 9% — ISMH. At the same time, the majority of patients with glomerular hyperfiltration was recorded in patients with ISMH (20,5%), and with hypofiltration — IDMH (29%) and SDMH (23,6%).Conclusion. Modern technologies of clustering increase the effectiveness of risk stratification for patients with MH, and contribute to the personification of preventive and therapeutic programs.

scholarly journals Masked Hypertension and Elevated Nighttime Blood Pressure in CKD: Prevalence and Association with Target Organ Damage

2016 ◽  
Vol 11 (4) ◽  
pp. 642-652 ◽  
Author(s):  
Paul E. Drawz ◽  
Arnold B. Alper ◽  
Amanda H. Anderson ◽  
Carolyn S. Brecklin ◽  
Jeanne Charleston ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Masked Hypertension ◽  
Nighttime Blood Pressure

scholarly journals Seasonal Variation of Home Blood Pressure and Its Association With Target Organ Damage: The J-HOP Study (Japan Morning Surge-Home Blood Pressure)

2020 ◽  
Vol 33 (7) ◽  
pp. 620-628
Author(s):  
Keisuke Narita ◽  
Satoshi Hoshide ◽  
Takeshi Fujiwara ◽  
Hiroshi Kanegae ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Seasonal Variation ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Cross Sectional Study ◽  
Home Blood Pressure ◽  
Target Organ ◽  
Masked Hypertension ◽  
Cardiovascular Risks ◽  
Cross Sectional

Abstract Background Although seasonal variation of home blood pressure (BP) has been reported to be higher in winter, seasonal difference in home BP (HBP) and its association with target organ damage (TOD) remains unclear. Methods This is a cross-sectional study using the dataset from the Japan Morning Surge-Home Blood Pressure (J-HOP) study to assess seasonal differences in HBP, prevalence of masked hypertension, and association of HBP with TOD. The J-HOP study is a nationwide, multicenter prospective study whose participants with cardiovascular risks underwent morning and evening HBP measurements for a 14-day period in 71 institutions throughout Japan. Urine albumin–creatinine ratio (UACR) and serum-B-type natriuretic peptide (BNP) were obtained at enrollment. Results Among 4,267 participants (mean age, 64.9 ± 10.9 years; 46.9% male; 91.4% hypertensives), 1,060, 979, 1,224, and 1,004 participants were enrolled in spring, summer, autumn, and winter, respectively. Morning and evening home systolic/diastolic BP levels, and prevalence of masked hypertension (office BP &lt;140/90 mm Hg and HBP ≥135/85 mm Hg) were significantly lower in summer than other seasons after adjustment for covariates. When we assessed the interaction between BP parameters and each season for an association with TOD, we found the association between morning home diastolic BP and each of UACR and BNP was stronger in winter than other seasons (both P for interaction &lt;0.05). Conclusions In this study, we revealed that the prevalence of masked hypertension was higher in other seasons than in summer and found a notable association between morning home diastolic BP and TOD in winter.

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