Awake systolic blood pressure variability independently predicted intima-media thickness (P=0.015), left ventricular mass index (P=0.028), and microalbuminuria (P=0.01) in suspected hypertension.
Cross-Sectional (n=180)
Does awake systolic blood pressure variability correlate with target-organ damage in untreated subjects with suspected hypertension?
Awake systolic blood pressure variability independently correlates with sub-clinical target-organ damage in patients with newly suspected hypertension, suggesting it is an early marker of cardiovascular risk.
p-value: p=0.001 and 0.003 for trend
Growing evidence associates blood pressure (BP) variability with cardiovascular events in hypertensive patients. Here we tested the existence of a relationship between awake BP variability and target-organ damage in subjects referred for suspected hypertension. Systolic and diastolic BP variability were assessed as the standard deviation of the mean out of 24-hour, awake and asleep BP recordings in 180 untreated subjects, referred for suspected hypertension. Measurements were done at 15-minute intervals during daytime and 30-minute intervals during nighttime. Left ventricular mass index (by echo), intima-media thickness (by carotid ultrasonography), and microalbuminuria were assessed as indices of cardiac, vascular and renal damage, respectively. Intima-media thickness and left ventricular mass index progressively increased across tertiles of awake systolic BP variability (P for trend=0.001 and 0.003, respectively). Conversely, microalbuminuria was similar in the 3 tertiles (P=NS). Multivariable analysis identified age (P=0.0001), awake systolic BP (P=0.001), awake systolic BP variability (P=0.015) and diastolic BP load (P=0.01) as independent predictors of intima-media thickness; age (P=0.0001), male sex (P=0.012), awake systolic (P=0.0001) and diastolic BP (P=0.035), and awake systolic BP variability (P=0.028) as independent predictors of left ventricular mass index; awake systolic BP variability (P=0.01) and diastolic BP load (P=0.01) as independent predictors of microalbuminuria. Therefore, awake systolic BP variability by non-invasive ambulatory BP monitoring correlates with sub-clinical target-organ damage, independent of mean BP levels. Such relationship, found in subjects referred for recently suspected hypertension, likely appears early in the natural history of hypertension.
Tatasciore et al. (Tue,) conducted a cross-sectional in Suspected hypertension (n=180). Awake systolic blood pressure variability vs. Lower tertiles of awake systolic blood pressure variability was evaluated on Target-organ damage (intima-media thickness, left ventricular mass index, and microalbuminuria) (p=0.001 and 0.003 for trend). Awake systolic blood pressure variability independently predicted intima-media thickness (P=0.015), left ventricular mass index (P=0.028), and microalbuminuria (P=0.01) in suspected hypertension.