Key result
Blood pressure variability (OR 1.04; 95% CI 1.00-1.08; P=0.04) and active phase systolic blood pressure on ambulatory monitoring were independent predictors of target organ damage.
Why the study?
The association of short-term blood pressure variability with target organ damage is not clearly established.
Does ambulatory blood pressure monitoring better predict target organ damage compared to office blood pressure measurements in clinic patients?
Observational (n=968)
Does ambulatory blood pressure monitoring better predict target organ damage compared to office blood pressure measurements in clinic patients?
Odds Ratio: 1.04 (95% CI 1–1.08)
p-value: p=0.04
Ambulatory blood pressure monitoring parameters, specifically blood pressure variability and active phase systolic BP, are significant predictors of target organ damage, supporting its routine use in hypertension management.
ABPM BP variability was associated with target organ damage; hypothesis-generating and should not yet change practice.
Introduction: High blood pressure (BP) is an important risk factor for cardiovascular diseases. The association of short-term BP variability (BPV) with target organ damage (TOD) is not clearly established. We conducted this observational study to evaluate the degree of concordance between Office BP measurements (OBPM) and ambulatory BP monitoring (ABPM) and to study the association of ABPM parameters on TOD. Materials and Methods: Patients attending clinics of the authors between January 2018 and August 2019 were enrolled. Their BP status was determined by OBPM and ABPM and the degree of concordance analyzed. ABPM parameters between those with TOD and without TOD were compared using appropriate statistical measures. Results: Data from 968 subjects (males 61.5%, mean age 59.39 ± 14.86 years) were analyzed. Masked hypertension (HTN) and white coat HTN were seen in 138 (14.3%) and 50 (5.2%) participants, respectively. There was moderate concordance between ABPM and OBPM readings (Cohen's κ =0.571, 95% confidence interval [CI]: 0.445, 0.595, P < 0.001). There were 530 (54.8%) nondippers and 189 (19.5%) reverse dippers. High morning surge (MS) was seen in 193 patients (19.9%) and TOD was seen in 378 patients (39%). Among all the ABPM parameters which were significantly associated with TOD on univariate analysis, only BPV ( P = 0.04, odds ratio [OR]: 1.04, 95% CI: 1.00, 1.08) and systolic BP in active phase ( P = 0.01, OR: 1.02, 95% CI: 1.00, 1.04) were found to be predictors of TOD after multiple logistic regression analysis. Dipping status and MS were not associated with TOD. Conclusions: ABPM is a useful tool for diagnosis and accurate categorization of HTN. The analysis of ABPM parameters helps to identify the patients with BPV which has important implications for the prevention of TOD. ABPM is recommended in all individuals with cardiometabolic risk profile or with established TOD even with normal office BP readings.
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Hegde et al. (2022) conducted an observational in Hypertension (n=968). Blood pressure variability (BPV) was evaluated on Target organ damage (TOD) (OR 1.04, 95% CI 1.00-1.08, p=0.04). Blood pressure variability (OR 1.04; 95% CI 1.00-1.08; P=0.04) and active phase systolic blood pressure on ambulatory monitoring were independent predictors of target organ damage.
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