Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects

被引:357
作者
Tatasciore, Alfonso
Renda, Giulia
Zimarino, Marco
Soccio, Manola
Bilo, Grzegorz
Parati, Gianfranco
Schillaci, Giuseppe
De Caterina, Raffaele
机构
[1] Univ G DAnnunzio, Inst Cardiol, Osped S Camillo Lellis, I-66100 Chieti, Italy
[2] Univ G DAnnunzio, Ctr Excellence Aging, I-66100 Chieti, Italy
[3] Univ Milano Bicocca, Dept Cardiol, S Luca Hosp, Italian Auxol Inst, Milan, Italy
[4] Univ Milano Bicocca, Dept Clin Med & Prevent, Milan, Italy
[5] Univ Perugia, Dept Clin & Expt Med, I-06100 Perugia, Italy
关键词
hypertension; blood pressure variability; target; organ damage; intima; media thickness; left ventricular mass index;
D O I
10.1161/HYPERTENSIONAHA.107.090084
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Growing evidence associates blood pressure (BP) variability with cardiovascular events in hypertensive patients. Here we tested the existence of a relationship between awake BP variability and target-organ damage in subjects referred for suspected hypertension. Systolic and diastolic BP variability were assessed as the standard deviation of the mean out of 24-hour, awake and asleep BP recordings in 180 untreated subjects, referred for suspected hypertension. Measurements were done at 15-minute intervals during daytime and 30-minute intervals during nighttime. Left ventricular mass index (by echo), intima-media thickness (by carotid ultrasonography), and microalbuminuria were assessed as indices of cardiac, vascular and renal damage, respectively. Intima-media thickness and left ventricular mass index progressively increased across tertiles of awake systolic BP variability (P for trend -0.001 and 0.003, respectively). Conversely, microalbuminuria was similar in the 3 tertiles (P=NS). Multivariable analysis identified age (P=0.0001), awake systolic BP (P=0.001), awake systolic BP variability (P=0.015) and diastolic BP load (P=0.01) as independent predictors of intima-media thickness; age (P=0.0001), male sex (P=0.012), awake systolic (P=0.0001) and diastolic BP (P=0.035), and awake systolic BP variability (P=0.028) as independent predictors of left ventricular mass index; awake systolic BP variability (P=0.01) and diastolic BP load (P=0.01) as independent predictors of microalbuminuria. Therefore, awake systolic BP variability by non-invasive ambulatory BP monitoring correlates with sub-clinical target-organ damage, independent of mean BP levels. Such relationship, found in subjects referred for recently suspected hypertension, likely appears early in the natural history of hypertension.
引用
收藏
页码:325 / 332
页数:8
相关论文
共 44 条
[1]  
Armitage P, 1987, Statistical methods in medical research, V2nd
[2]   How to improve the assessment of 24-h blood pressure variability [J].
Bilo, G ;
Giglio, A ;
Styczkewicz, K ;
Caldara, G ;
Kawecka-Jaszcz, K ;
Mancia, G ;
Parati, G .
BLOOD PRESSURE MONITORING, 2005, 10 (06) :321-323
[3]   Carotid intima-media thickness measurements in intervention studies - Design options, progression rates, and sample size considerations: A point of view [J].
Bots, ML ;
Evans, GW ;
Riley, WA ;
Grobbee, DE .
STROKE, 2003, 34 (12) :2985-2994
[4]   Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [J].
Chobanian, AV ;
Bakris, GL ;
Black, HR ;
Cushman, WC ;
Green, LA ;
Izzo, JL ;
Jones, DW ;
Materson, BJ ;
Oparil, S ;
Wright, JT ;
Roccella, EJ .
HYPERTENSION, 2003, 42 (06) :1206-1252
[5]   Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension [J].
Clement, DL ;
De Buyzere, ML ;
De Bacquer, DA ;
de Leeuw, PW ;
Duprez, DA ;
Fagard, RH ;
Gheeraert, PJ ;
Missault, LH ;
Braun, JJ ;
Six, RO ;
Van Der Niepen, P ;
O'Brien, E .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (24) :2407-2415
[6]   PREDICTION OF CREATININE CLEARANCE FROM SERUM CREATININE [J].
COCKCROFT, DW ;
GAULT, MH .
NEPHRON, 1976, 16 (01) :31-41
[7]   Reduced nocturnal fall in blood pressure, assessed by two ambulatory blood pressure monitorings and cardiac alterations in early phases of untreated essential hypertension [J].
Cuspidi, C ;
Michev, I ;
Meani, S ;
Severgnini, B ;
Fusi, V ;
Corti, C ;
Salerno, M ;
Valerio, C ;
Magrini, F ;
Zanchetti, A .
JOURNAL OF HUMAN HYPERTENSION, 2003, 17 (04) :245-251
[8]   Low-density lipoprotein level reduction by the 3-hydroxy-3-methylglutaryl coenzyme-A inhibitor simvastatin is accompanied by a related reduction of F2-isoprostane formation in hypercholesterolemic subjects -: No further effect of vitamin E [J].
De Caterina, R ;
Cipollone, F ;
Filardo, FP ;
Zimarino, M ;
Bernini, W ;
Lazzerini, G ;
Bucciarelli, T ;
Falco, A ;
Marchesani, P ;
Muraro, R ;
Mezzetti, A ;
Ciabattoni, G .
CIRCULATION, 2002, 106 (20) :2543-2549
[9]   ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT-VENTRICULAR HYPERTROPHY - COMPARISON TO NECROPSY FINDINGS [J].
DEVEREUX, RB ;
ALONSO, DR ;
LUTAS, EM ;
GOTTLIEB, GJ ;
CAMPO, E ;
SACHS, I ;
REICHEK, N .
AMERICAN JOURNAL OF CARDIOLOGY, 1986, 57 (06) :450-458
[10]   CONTINUOUS VS INTERMITTENT BLOOD-PRESSURE MEASUREMENTS IN ESTIMATING 24-HOUR AVERAGE BLOOD-PRESSURE [J].
DIRIENZO, M ;
GRASSI, G ;
PEDOTTI, A ;
MANCIA, G .
HYPERTENSION, 1983, 5 (02) :264-269