Key result
Elevated peripheral blood pressure increased the risk of abnormal albumin-creatinine ratio (OR 2.264), while elevated carotid-femoral pulse wave velocity alone increased the risk of left ventricular hypertrophy (OR 1.868).
Why the study?
Assessment of target organ damage is key in hypertension evaluation, and this study aimed to analyze the risk of target organ damage across different phenotypes of peripheral blood pressure and carotid-femoral pulse wave velocity.
Do different phenotypes of peripheral blood pressure and carotid-femoral pulse wave velocity increase the risk of specific target organ damage in adults?
Cross-Sectional (n=1,257)
No
Do different phenotypes of peripheral blood pressure and carotid-femoral pulse wave velocity increase the risk of specific target organ damage in adults?
Elevated peripheral blood pressure is primarily associated with an increased risk of albuminuria, whereas elevated arterial stiffness (cf-PWV) alone is more strongly associated with left ventricular hypertrophy.
Objectives Assessment of target organ damage (TOD) is an important part of the diagnosis and evaluation of hypertension. Carotid-femoral pulse wave velocity (cf-PWV) is considered to be the gold-standard for noninvasive arterial stiffness assessment. This study aims to analyze the risk of TOD in people with different phenotypes of peripheral blood pressure and cf-PWV. Methods The study cohort was recruited from December 2017 to September 2021 at Ruijin Hospital in Shanghai. It was divided into 4 groups according to peripheral blood pressure (pBP) and cf-PWV. TOD was assessed as carotid intima-media thickness (CIMT), chronic kidney disease (CKD), urinary albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR) and left ventricular mass index (LVMI). Results A total of 1,257 subjects (mean age 53.13 ± 12.65 years, 64.2% males) was recruited. Age, body mass index (BMI) and fasting blood glucose (FBG), as well as peripheral systolic blood pressure (pSBP), peripheral diastolic blood pressure (pDBP), peripheral pulse pressure (pPP) were significantly different in the four groups (P < 0.01). eGFR, ACR, LVMI and CIMT were significantly different among different groups (P < 0.01). The risk of ACR abnormality was significantly higher in the group with elevated pBP (P = 0.005, OR 2.264, 95%CI 1.277–4.016; and in the group with elevated pBP and cf-PWV (P = 0.003, OR 1.482, 95%CI 1.144–1.920), while left ventricular hypertrophy (LVH) was significantly higher in the group with elevated cf-PWV (P = 0.002, OR 1.868, 95%CI 1.249–2.793). Conclusion Different profiles based on the status of PBP and cf-PWV associated with different TOD. Individuals with higher pBP have an increased risk of ACR abnormality, while individuals with only cf-PWV elevated have a higher risk of LVH.
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Chao et al. (2022) conducted a cross-sectional in Hypertension and Target Organ Damage (n=1,257). Elevated peripheral blood pressure vs. Normal blood pressure and normal carotid-femoral pulse wave velocity was evaluated on Abnormal urinary albumin-creatinine ratio (ACR) (OR 2.264, 95% CI 1.277-4.016, p=0.005). Elevated peripheral blood pressure increased the risk of abnormal albumin-creatinine ratio (OR 2.264), while elevated carotid-femoral pulse wave velocity alone increased the risk of left ventricular hypertrophy (OR 1.868).
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