Key result
Baseline self-blood pressure monitoring <135/85 mm Hg was associated with a more favorable evolution of target organ damage compared to ≥135/85 mm Hg at 1 year.
Why the study?
Does a lower baseline self-blood pressure monitoring (SBPM) cutoff predict a more favorable evolution of target organ damage in newly diagnosed untreated hypertensive patients?
Cohort (n=466)
Does a lower baseline self-blood pressure monitoring (SBPM) cutoff predict a more favorable evolution of target organ damage in newly diagnosed untreated hypertensive patients?
Baseline SBPM values <130/80 mm Hg are associated with a better evolution of target organ damage compared to <135/85 mm Hg in newly diagnosed untreated hypertensive patients.
Answers are grounded in this paper and cite their sources.
Supports SBPM-guided stratification in new hypertension but should not change practice; extends observational data on target organ damage while leaving optimal thresholds open.
BACKGROUND: To determine the prognostic value of various self-blood pressure (BP) monitoring (SBPM) cutoff at the time of diagnosis. METHODS: Cohort of 466 newly diagnosed and never-treated hypertensive patients. At baseline and at 1 year, the patients underwent a physical examination, clinic BP (CBP), SBPM, and ambulatory BP monitoring (ABPM), fasting blood and urine analysis, electrocardiogram (ECG), and retinography. The diagnosis of hypertension was made based on CBP average of two readings, separated by 2 min, taken over three different days, with results ≥ 140/90 mm Hg. At 1-year follow-up, target organ damage (TOD) evolution was classified as favorable or unfavorable. RESULTS: Mean age was 57.4 years, 56.8% were men. Adjusted multivariate analysis showed that hypertensive patients with baseline SBPM <135/85 mm Hg had a more favorable evolution of left ventricular hypertrophy (LVH) (odds ratio (OR): 1.9; 95% confidence interval (CI): 1.5-2.5), high urinary albumin excretion rate (UAER) (OR: 6.9; 95% CI: 3.4-14.4), and more favorable amount of TOD evolution (OR: 1.7; 95% CI: 1.4-2.0) than those with baseline SBPM ≥ 135/85 mm Hg. Patients with baseline SBPM <130/80 mm Hg, or <125/80 mm Hg had a more favorable evolution of the amount of TOD (OR: 2.7; 95% CI: 2.0-3.6, and OR: 2.9; 95% CI: 2.1-4.1, respectively) at 1 year than those with baseline SBPM <135/85 mm Hg. CONCLUSIONS: Baseline SBPM values <130/80 mm Hg is associated with better evolution of amount of TOD than SBPM values <135/85 mm Hg. These results would support a clinical trial to test a SBPM threshold <130/80 as an optimal pressure not needing pharmacological treatment among those with CBP ≥ 140/90.
No takes yet. Share an insight, caveat, or question.
Tuero et al. (2012) conducted a cohort in Newly diagnosed and never-treated hypertension (n=466). Baseline self-blood pressure monitoring (SBPM) <135/85 mm Hg vs. Baseline SBPM ≥ 135/85 mm Hg was evaluated on Favorable evolution of the amount of target organ damage (TOD) (OR 1.7, 95% CI 1.4-2.0). Baseline self-blood pressure monitoring <135/85 mm Hg was associated with a more favorable evolution of target organ damage compared to ≥135/85 mm Hg at 1 year.
Synapse has enriched 10 related papers. Consider them for comparative context: