Key result
Sleep blood pressure ≥120/70 mmHg is linked to LVH in hypertensive patients.
Why the study?
Although hypertension and cardiovascular risk factors cause target organ damage, the relationship between blood pressure and clinical and biochemical parameters in developing target organ damage needed evaluation.
Cohort (n=162)
p-value: p=0.044
In hypertensive patients, nocturnal blood pressure is correlated with left ventricular hypertrophy, while metabolic factors and age predict other target organ damages over long-term follow-up.
Nocturnal BP ≥120/70 mmHg may flag LVH risk in hypertension; observational data leave causal role and practice change open.
BACKGROUND: The causal relationship between systemic arterial hypertension and target organ damage (TOD) is well known, as well as the association with cardiovascular risk factors (CV). Ambulatory blood pressure monitoring (ABPM) is important in monitoring hypertension and assessing the risk of TOD. OBJECTIVE: To evaluate the relationship between blood pressure (BP) and clinical and biochemical parameters in the development of TOD in hypertensive patients. METHODS: This was a retrospective cohort study with 162 hypertensive patients followed for an average period of 13 years. The TOD investigated were left ventricular hypertrophy (LVH), microalbuminuria, coronary artery disease (CAD) and stroke. Blood pressure was assessed by ABPM and LVH using echocardiogram and electrocardiogram, respectively. Biochemical-metabolic tests and 24-hour microalbuminuria were performed at baseline and follow-up. The P-value <0.05 was considered significant. RESULTS: The average age was 69±11.8 years, with a predominance of women (64.8%), white ethnicity (79.6%) and diabetics (78.4%). ABPM showed a significant reduction in BP values during follow-up, although without association with TOD (microalbuminuria, stroke, and CAD), except for LVH that showed a correlation with sleep BP ≥120/70 mmHg (P=0.044). The most frequent TODs were LVH (29.6%), microalbuminuria (26.5%), CAD (19.8%) and stroke (17.3%). In the follow-up, there was an association between LVH and diabetes; microalbuminuria was associated with diabetes and triglycerides; stroke was associated with HDL-cholesterol (HDL-c), microalbuminuria and carotid disease. CAD showed a relationship with age and HDL-c. CONCLUSION: Predictive factors for TOD are age, microalbuminuria, diabetes, HDL-c, triglycerides and carotid disease. Nocturnal BP is correlated with LVH. The absence of a relationship between ABPM and other TODs can be explained by the use of effective drugs, improvement of metabolic and blood pressure parameters.
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Landim et al. (2021) conducted a cohort in Hypertension (n=162). Blood pressure and clinical/biochemical parameters was evaluated on Target organ damage (left ventricular hypertrophy, microalbuminuria, coronary artery disease, and stroke) (p=0.044). Sleep blood pressure ≥120/70 mmHg correlated with left ventricular hypertrophy (P=0.044) in hypertensive patients, while age, diabetes, and lipids predicted other target organ damage.
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