Key result
Office systolic blood pressure variability linked to ~10% higher risk of hypertension-mediated organ damage.
Why the study?
Sex differences in blood pressure regulation may modify associations between blood pressure variability and hypertension-mediated organ damage, but organ-specific effects remain unclear.
Do sex differences modify the association between blood pressure variability and hypertension-mediated organ damage in hypertensive patients?
Observational (n=398)
Yes
Do sex differences modify the association between blood pressure variability and hypertension-mediated organ damage in hypertensive patients?
Odds Ratio: 1.1 (95% CI 1.05–1.16)
p-value: p=<0.01
Sex significantly modifies the relationship between blood pressure variability and cardiac target organ damage, suggesting that precision hypertension management should incorporate sex-specific monitoring strategies.
BACKGROUND: Sex differences in blood pressure (BP) regulation may modify associations between BP variability (BPV) and hypertension-mediated organ damage (HMOD), but organ-specific effects remain unclear. METHODS: We studied 398 hypertensive patients from a multicenter home BP monitoring registry. The office-home BP difference (ΔBP = office-home) was analyzed as a single continuous exposure variable, with positive values indicating the white-coat effect and negative values indicating the masked effect. Multivariable regression examined sex-specific associations of BPV patterns with HMOD, including electrocardiographic left ventricular hypertrophy (ECG-LVH) and microalbuminuria/proteinuria. RESULTS: Women demonstrated higher home systolic BPV than men despite similar mean BP levels (P < .01). Office BP was the primary determinant of white-coat phenotypes (office SBP: adjusted odds ratio [aOR] 1.29 [95% CI: 1.22-1.37]; office DBP: aOR 1.27 [1.19-1.37], both P < .01), while home BP predicted masked phenotype (home SBP: aOR 1.23 [1.12-1.39]; home DBP: aOR 1.34 [1.23-1.48], both P < .01). White-coat effects showed protective associations with total HMOD (systolic aOR 0.97 [0.94-1.00], P < .05), while office BPV demonstrated consistent positive associations (systolic aOR 1.10 [1.05-1.16]; diastolic aOR 1.12 [1.05-1.20], both P < .01). Critically, significantly sex interaction emerged for ECG-LVH, while microalbuminuria/proteinuria showed consistent associations across sexes. CONCLUSIONS: Sex fundamentally modifies BP patterns-HMOD relationships in an organ-specific manner. Cardiac target organ damage requires sex-attentive monitoring approaches, while renal damage shows universal associations with office BPV. These findings support precision medicine approaches to hypertension management incorporating sex-specific BP assessment strategies.
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Cha et al. (2025) conducted an observational in Hypertension (n=398). Blood pressure variability and office-home BP difference was evaluated on Total hypertension-mediated organ damage (HMOD) (aOR 1.10, 95% CI 1.05-1.16, p=<0.01). Office systolic blood pressure variability was positively associated with total hypertension-mediated organ damage (aOR 1.10; 95% CI 1.05-1.16; P<0.01), with sex modifying the effect for ECG-LVH.
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