Key result
In hypertensive patients, riser blood pressure patterns were associated with higher carotid intima-media thickness compared to extreme dippers (0.794 vs 0.716 mm, P<0.05).
Why the study?
Do ambulatory blood pressure monitoring parameters predict vascular, cardiac, and renal target organ damage in patients with recently diagnosed hypertension?
Cross-Sectional (n=353)
Do ambulatory blood pressure monitoring parameters predict vascular, cardiac, and renal target organ damage in patients with recently diagnosed hypertension?
Ambulatory blood pressure monitoring parameters, specifically pulse pressure and nocturnal blood pressure fall, are significant predictors of subclinical vascular, cardiac, and renal target organ damage in newly diagnosed hypertensive patients.
Riser patterns may aid ABPM risk stratification in hypertension; leaves open whether modifying nocturnal dipping reduces target organ damage.
OBJECTIVES: To analyse the relationship between various parameters derived from ambulatory blood pressure monitoring (ABPM) and vascular, cardiac and renal target organ damage. METHODS: A cross-sectional, descriptive study. It included 353 patients with short-term or recently diagnosed hypertension. PRIMARY MEASUREMENTS: ABPM, carotid intima-media thickness (IMT), Cornell voltage-duration product (Cornell VDP), glomerular filtration rate and albumin/creatinine ratio to assess vascular, cardiac and renal damage. RESULTS: Two hundred and twenty-three patients (63.2%) were males, aged 56.12+/-11.21 years. The nocturnal fall in blood pressure was 11.33+/-8.41, with a dipper pattern in 49.0% (173), nondipper in 30.3% (107), extreme dipper in 12.7% (45) and riser in 7.9% (28). The IMT was lower in the extreme dipper (0.716+/-0.096 mm) and better in the riser pattern (0.794+/-0.122 mm) (P<0.05). The Cornell VDP and albumin/creatinine ratio were higher in the riser pattern (1818.94+/-1798.63 mm/ms and 140.78+/-366.38 mg/g, respectively) than in the other patterns. In the multivariate analysis after adjusting for age, sex and antihypertensive treatment, with IMT as dependent variable the 24-h pulse pressure (beta = 0.003), with Cornell VDP the rest pulse pressure (beta = 12.04), and with the albumin/creatinine ratio the percentage of nocturnal fall in systolic blood pressure (beta = -3.59), the rest heart rate (beta = 1.83) and the standard deviation of 24-h systolic blood pressure (beta = 5.30) remain within the equation. CONCLUSION: The estimated pulse pressure with ABPM is a predictor of vascular and cardiac organ damage. The nocturnal fall and the standard deviation in 24-h systolic blood pressure measured with the ABPM is a predictor of renal damage.
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García‐Ortiz et al. (2009) conducted a cross-sectional in short-term or recently diagnosed hypertension (n=353). Ambulatory blood pressure monitoring parameters (pulse pressure and nocturnal fall) was evaluated on Vascular, cardiac and renal target organ damage (assessed by IMT, Cornell VDP, GFR, and albumin/creatinine ratio). In hypertensive patients, riser blood pressure patterns were associated with higher carotid intima-media thickness compared to extreme dippers (0.794 vs 0.716 mm, P<0.05).
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