Why the study?
Assessing night-time BP remains challenging due to limited accessibility to ambulatory BP devices and costs, prompting investigation into whether daytime supine BP performs similarly in modeling vascular HMOD.
Does daytime supine blood pressure perform similarly to night-time blood pressure in predicting vascular hypertension-mediated organ damage in hypertensive patients?
Does daytime supine blood pressure perform similarly to night-time blood pressure in predicting vascular hypertension-mediated organ damage in hypertensive patients?
Daytime supine blood pressure may serve as a clinically useful and potentially superior surrogate for night-time BP in predicting hypertension-mediated organ damage when ambulatory monitoring is unavailable.
Answers are grounded in this paper and cite their sources.
Supine BP may surrogate night-time BP for HMOD assessment when ABPM unavailable; hypothesis-generating and requires prospective validation.
Night-time blood pressure (BP) is an important predictor of cardiovascular outcomes. Its assessment, however, remains challenging due to limited accessibility to ambulatory BP devices in many settings, costs, and other factors. We hypothesized that BP measured in a supine position during daytime may perform similarly to night-time BP when modeling their association with vascular hypertension-mediated organ damage (HMOD). Data from 165 hypertensive patients were used who as part of their routine clinic workup had a series of standardized BP measurements including seated attended office, seated and supine unattended office, and ambulatory BP monitoring. HMOD was determined by assessment of kidney function and pulse wave velocity. Correlation analysis was carried out, and univariate and multivariate models were fitted to assess the extent of shared variance between the BP modalities and their individual and shared contribution to HMOD variables. Of all standard non-24-hour systolic BP assessments, supine systolic BP shared the highest degree of variance with systolic night-time BP. In univariate analysis, both systolic supine and night-time BP were strong determinants of HMOD variables. In multivariate models, supine BP outperformed night-time BP as the most significant determinant of HMOD. These findings indicate that supine BP may not only be a clinically useful surrogate for night-time BP when ambulatory BP monitoring is not available, but also highlights the possibility that unattended supine BP may be more closely related to HMOD than other BP measurement modalities, a proposition that requires further investigations in prospective studies.
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Nolde et al. (2020) studied this question.
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