Key result
The decrease in central systolic blood pressure during antihypertensive treatment was independently associated with reductions in log-transformed UACR and LVMI.
Why the study?
Does the reduction in central blood pressure correlate with improvements in hypertensive target organ damage independently of peripheral blood pressure?
Observational (n=180)
Does the reduction in central blood pressure correlate with improvements in hypertensive target organ damage independently of peripheral blood pressure?
Reductions in central blood pressure correlate with improvements in hypertensive target organ damage independently of peripheral clinic and home blood pressure, suggesting central BP is an important therapeutic target.
Answers are grounded in this paper and cite their sources.
Central BP reduction may track less organ damage beyond peripheral BP; leaves open whether it should guide therapy.
BACKGROUND: Some previous studies have shown that central blood pressure (BP) is more closely related to cardiovascular risks than brachial BP. This study compared the correlations between asymptomatic organ damages and each of central BP, brachial clinic BP, and home BP during antihypertensive treatment. METHODS: In the Japan Morning Surge-Target Organ Protection (J-TOP) study, which compared bedtime or awakening dosing of candesartan (+diuretics as needed) among subjects with home systolic BP (SBP) higher than 135 mm Hg, we evaluated 180 hypertensive patients who successfully underwent pulse wave analysis by HEM-9000AI and measured their urinary albumin/creatinine ratio (UACR) and left ventricular mass index (LVMI) (n = 144) at baseline and after 6 months of treatment. RESULTS: During antihypertensive treatment, significant reductions were found in central SBP, UACR, and LVMI (all P < 0.001). Multiple regression analyses showed that the decrease in central SBP was associated with those of log-transformed UACR (β = 0.24, P < 0.01) and LVMI (β = 0.23, P = 0.04), independently of the decrease in both clinic and home SBP. The goodness-of-fit of the association between the reduction in SBP and the UACR (P < 0.01) or LVMI (P = 0.04) was improved by adding central SBP to the SBP measurement. CONCLUSION: These findings suggest that the change in central BP could be an important therapeutic target during antihypertensive treatment, in addition to peripheral clinic and home BP.
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Shimizu et al. (2014) conducted an observational in Hypertension (n=180). Decrease in central systolic blood pressure was evaluated on Decrease in log-transformed UACR and LVMI (β = 0.24 for UACR, β = 0.23 for LVMI, p=<0.01 for UACR, 0.04 for LVMI). The decrease in central systolic blood pressure during antihypertensive treatment was independently associated with reductions in log-transformed UACR and LVMI.
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