scholarly journals Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with primary glomerular disease

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruo-wei Wen ◽  
Xiao-qiu Chen ◽  
Ye Zhu ◽  
Jian-ting Ke ◽  
Yi Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Glomerular Disease ◽  
Regression Analyses ◽  
Clinic Blood Pressure ◽  
Multivariate Logistic Regression ◽  
Primary Glomerular Disease

Abstract Background Blood pressure is an important and modifiable cardiovascular risk factor. Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. The goal of this study was to investigate whether ambulatory blood pressure is better associated with TOD than clinic blood pressure in patients with primary glomerular disease. Methods 1178 patients with primary glomerular disease were recruited in this cross-sectional study. TOD were assessed by the following 4 parameters: left ventricular mass index (LVMI or LVH, left ventricular hypertrophy), estimated glomerular filtration rate (eGFR< 60 ml/min/1.73m2), albumin-to-creatinine ratio (ACR ≥ 30 mg/g) and carotid intima-media thickness (cIMT) or plaque. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to evaluate the relationship between ambulatory or clinic systolic blood pressure (SBP) indexes and TOD. Results Among 1178 patients (mean age, 39 years,54% men), 116, 458, 1031 and 251 patients had LVH, eGFR < 60 ml/min/1.73m2, ACR ≥ 30 mg/g and cIMT≥0.9 mm or plaque respectively. Area under ROC curves for TOD in ambulatory SBP, especially nighttime SBP, was greater than that in clinic SBP (P < 0.05). Multivariate logistic regression analyses showed that 24 h SBP, daytime SBP and nighttime SBP were significantly associated with LVH, eGFR< 60 ml/min/1.73m2 and ACR ≥ 30 mg/g after adjustment for clinic SBP, while the association of clinic SBP was attenuated after further adjustment for nighttime SBP. Conclusions Ambulatory blood pressure, especially nighttime blood pressure, is probably superior to clinic blood pressure and has a significant association with TOD in primary glomerular disease patients.

scholarly journals Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with primary glomerular disease

2020 ◽  
Author(s):  
ruowei wen ◽  
xiaoqiu chen ◽  
ye zhu ◽  
jianting ke ◽  
yi du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Glomerular Disease ◽  
Regression Analyses ◽  
Clinic Blood Pressure ◽  
Multivariate Logistic Regression ◽  
Primary Glomerular Disease

Abstract Background: Blood pressure is an important and modifiable cardiovascular risk factor. Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. The goal of this study was to investigate whether ambulatory blood pressure is better associated with TOD than clinic blood pressure in patients with primary glomerular disease. Methods: 1178 patients with primary glomerular disease were recruited in this cross-sectional study. TOD were assessed by the following 4 parameters: left ventricular mass index (LVMI or LVH, left ventricular hypertrophy), estimated glomerular filtration rate (eGFR<60ml/min/1.73m 2 ), albumin-to-creatinine ratio (ACR≥30mg/g) and carotid intima-media thickness (cIMT) or plaque. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to evaluate the relationship between ambulatory or clinic systolic blood pressure (SBP) indexes and TOD. Results: Among 1178 patients (mean age, 39 years,54% men), 116, 458, 1031 and 251 patients had LVH, eGFR < 60 ml/min/1.73m 2 , ACR≥30mg/g and cIMT≥0.9mm or plaque respectively. Area under ROC curves for TOD in ambulatory SBP, especially nighttime SBP, was greater than that in clinic SBP ( P <0.05). Multivariate logistic regression analyses showed that 24h SBP, daytime SBP and nighttime SBP were significantly associated with LVH, eGFR<60 ml/min/1.73m 2 and ACR≥30mg/g after adjustment for clinic SBP, while the association of clinic SBP was attenuated after further adjustment for nighttime SBP. Conclusions: Ambulatory blood pressure, especially nighttime blood pressure, is probably superior to clinic blood pressure in predicting TOD in patients with primary glomerular disease.

scholarly journals Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with primary glomerular disease

2020 ◽  
Author(s):  
ruowei wen ◽  
xiaoqiu chen ◽  
ye zhu ◽  
jianting ke ◽  
yi du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Glomerular Disease ◽  
Target Organ ◽  
Clinic Blood Pressure ◽  
Multivariate Logistic Regression ◽  
Primary Glomerular Disease

Abstract Background: Blood pressure is an important and modifiable cardiovascular risk factor. Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. The goal of this study was to investigate whether ambulatory blood pressure is better associated with TOD than clinic blood pressure in patients with primary glomerular disease. Methods: 1178 patients with primary glomerular disease were recruited in this cross-sectional study. TOD were assessed by the following 4 parameters: left ventricular mass index (LVMI or LVH, left ventricular hypertrophy), estimated glomerular filtration rate (eGFR<60ml/min/1.73m 2 ), albumin-to-creatinine ratio (ACR≥30mg/g) and carotid intima-media thickness (cIMT) or plaque. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to evaluate the relationship between ambulatory or clinic systolic blood pressure (SBP) indexes and TOD. Results: Among 1178 patients (mean age, 39 years,54% men), 116, 458, 1031 and 251 patients had LVH, eGFR < 60 ml/min/1.73m 2 , ACR≥30mg/g and cIMT≥0.9mm or plaque respectively. Area under ROC curves for TOD in ambulatory SBP, especially nighttime SBP, was greater than that in clinic SBP ( P <0.05). Multivariate logistic regression analyses showed that 24h SBP, daytime SBP and nighttime SBP were significantly associated with LVH, eGFR<60 ml/min/1.73m 2 and ACR≥30mg/g after adjustment for clinic SBP, while the association of clinic SBP was attenuated after further adjustment for nighttime SBP. Conclusions: Ambulatory blood pressure, especially nighttime blood pressure, is superior to clinic blood pressure in estimating TOD in patients with primary glomerular disease. Key Words: Ambulatory blood pressure, Clinic blood pressure, Target organ damage, Primary glomerular disease

The effects of nocturnal dipping on cardiovascular outcomes and proteinuria in essential hypertensive patients

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 279-286 ◽  
Author(s):  
Yusuf Selcoki ◽  
Burak Uz ◽  
Nuket Baybek ◽  
Ali Akcay ◽  
Beyhan Eryonucu
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Pressure Monitoring ◽  
Hypertensive Patients ◽  
Spot Urine

AbstractIndividuals who do not have a 10% to 20% reduction in blood pressure (BP) during the night are known as ‘nondippers’. Non-dipping patterns in hypertensive patients have been shown to be associated with an excess of target organ damage and other adverse outcomes. The present study was designed to investigate the relationship between nocturnal BP pattern, defined on the basis of the ambulatory blood pressure monitoring (ABPM) recording, and cardiac and renal target organ damage in a population of at least one year treated essential hypertensive subjects. The present analysis involved 123 patients with treated essential hypertension attending the outpatient clinic of our centre. Each patient was subjected to the following procedures: blood sampling for routine blood chemistry, spot urine for proteinuria, 24-hour periods of ABPM, and echocardiography. In the ABPM period, a dipping pattern was observed in 65 of the 123 patients, and a non-dipping pattern in 58 patients. Body mass index was higher in the non-dippers (26 ± 4 versus 28 ± 4, p<0.05). The proteinuria in spot urine was significantly higher in the non-dippers (10 ± 6 versus 24 ± 48, p<0.03). Left ventricular mass, interventricular septum thickness, posterior wall thickness and left ventricular systolic diameter were significantly higher in the non-dippers compared to the dippers. Left ventricular diastolic function was similar in non-dipper cases, except E-wave deceleration time. In treated essential hypertensives the blunted or absent nocturnal fall in blood pressure can be a strong predictor of cardiac and renal events. Hypertensive patients should be evaluated by ambulatory blood pressure monitoring. To prevent patients at risk for morbidity and mortality casualities as a result of hypertension, patients should be evaluated by ambulatory blood pressure monitoring. This method can be utilized for exacting future follow-ups with the patient.

Prevalence, Biochemical and Clinical Characteristics of Resistant Hypertension

2018 ◽  
Vol 69 (10) ◽  
pp. 2845-2849
Author(s):  
Daniela Gurgus ◽  
Elena Ardeleanu ◽  
Carmen Gadau ◽  
Roxana Folescu ◽  
Ioan Tilea ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Resistant Hypertension ◽  
Clinical Characteristics ◽  
Salt Intake ◽  
Target Organ Damage ◽  
Multivariate Logistic Regression Analysis ◽  
Organ Damage ◽  
Left Ventricular ◽  
High Salt Intake

The objectives of the present study were to evaluate the prevalence of resistant hypertension (RH) in primary care setting and to analyse its biochemical and clinical characteristics. After 3 months of treatment and evaluation, 721 (14.01%) of 5,146 patients with hypertension did not reach target office blood pressure of [ 140/90 mmHg. After exclusion of �white-coat effect� with ambulatory blood pressure, of secondary and pseudo- resistant hypertension, prevalence of RH was 6.74%. Lifestyle factors associated with RH were physical inactivity, obesity, high salt intake, smoking and excessive alcohol ingestion. Compared to controlled hypertension, RH patients presented higher incidence of family history of cardiovascular disease (38.90% vs 25.94%), diabetes mellitus (34.87% vs 19.01%), impaired fasting glucose (21.91% vs 19.07%), target organ damage (29.1% vs 15.95%), and cardiovascular disease (27.09% vs 17.06%). Dyslipidaemia (52.90% vs 42.03%), fasting plasma glucose (116.10�38.9 vs 107.80�37.2), HbA1c (6.41�1.42 vs 5.96�0.94), serum creatinine (1.09�0.27 vs 1.03�0.24) and microalbuminuria (21.90% vs 10.95%) were significantly higher in RH. Predictors of RH, determined by a multivariate logistic regression analysis were left ventricular hypertrophy (OD 2.14, 95% CI 1.32-3.69), renal impairment expressed as eGFR [ 60 ml/min/1.73m2 (OD 1.62, 95% CI 1.21-2.21) and the presence of cardiovascular disease (OD 1.48, 95% CI 1.02-2.16).

Abstract 432: Race Differences in the Relationship between Urinary ET-1 and BP-related Target Organ Damage in Youth

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Gregory A Harshfield ◽  
Gregory A Harshfield ◽  
Jennifer Pollock ◽  
David Pollock
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Mass ◽  
Target Organ Damage ◽  
Albumin Excretion Rate ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Related Target ◽  
Ventricular Mass ◽  
Lv Mass

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.

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