Key result
Home and ambulatory blood pressure monitoring showed comparable correlations with left ventricular mass index (r=0.30 and r=0.31, respectively) as office blood pressure (r=0.31; all P<0.01).
Why the study?
The comparative association of home, ambulatory, and office blood pressure measurements with preclinical organ damage in young individuals remained to be evaluated.
Do home and ambulatory blood pressure measurements correlate better with preclinical organ damage than office blood pressure in children, adolescents, and young adults?
Cross-Sectional (n=251)
Do home and ambulatory blood pressure measurements correlate better with preclinical organ damage than office blood pressure in children, adolescents, and young adults?
In young individuals, home and ambulatory blood pressure monitoring provide comparable associations with preclinical organ damage, suggesting target organ damage is mainly determined by out-of-office rather than office blood pressure.
OBJECTIVES: To compare the association of home (HBP), ambulatory (ABP) and office blood pressure (OBP) measurements with preclinical organ damage in young individuals. METHODS: Individuals referred for elevated blood pressure and healthy volunteers aged 6-25 years were evaluated with OBP (2-3 visits), 7-day HBP and 24-h ABP monitoring. Organ damage was assessed by echocardiographic left ventricular mass index (LVMI), carotid ultrasonography [intima--media thickness (IMT)] and pulse wave velocity (PWV) using piezo-electronic or oscillometric technique. RESULTS: Analysis included 251 individuals (mean age 14 ± 3.9 years, 70.9% men: 31.1% children, 54.6% adolescents, 14.3% young adults) of whom 189 had LVMI, 123 IMT and 198 PWV measurements. Office, ambulatory and home hypertension was diagnosed in 29.5, 27.1 and 26.3% of participants. The agreement of OBP with ABP was 74.5% (kappa 0.37) and HBP 76.1% (kappa 0.41), with closer agreement between HBP and ABP (84.9%, kappa 0.61). LVMI gave comparable correlations with systolic OBP, 24-h ABP and HBP (r = 0.31/0.31/0.30, all P < 0.01). The same was the case for IMT (0.33/0.32/0.37, all P < 0.01) and piezo-electronic PWV (0.55/0.53/0.52, all P < 0.01), whereas oscillometric PWV gave stronger correlations with OBP than ABP or HBP. In linear regression analysis, the variation of LVMI was determined by night-time ABP, of IMT by HBP and of PWV by OBP and 24-h ABP. CONCLUSION: These data suggest that in young individuals, target organ damage is mainly determined by out-of-office rather than office BP. Home and ambulatory BP give comparable associations with preclinical organ damage.
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Zeniodi et al. (2020) conducted a cross-sectional in Elevated blood pressure (n=251). Home and ambulatory blood pressure monitoring vs. Office blood pressure monitoring was evaluated on Association with preclinical organ damage (LVMI, IMT, PWV) (p=<0.01). Home and ambulatory blood pressure monitoring showed comparable correlations with left ventricular mass index (r=0.30 and r=0.31, respectively) as office blood pressure (r=0.31; all P<0.01).
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