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Is blood pressure load associated, independently of blood pressure level, with target organ damage?

Ming Liu1, Yan Li, Fang-Fei Wei

  • 1Centre for Vascular Evaluations and Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Journal of Hypertension
|June 8, 2013
PubMed

Insights

Blood pressure load, the percentage of high readings, is linked to target organ damage. However, this association is not independent of the overall blood pressure level, suggesting current BP level is the primary driver.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Biology

Background:

  • Ambulatory blood pressure monitoring (ABPM) is crucial for hypertension assessment.
  • Blood pressure (BP) load, representing the burden of elevated readings, is a metric from ABPM.
  • The independent clinical significance of BP load in relation to target organ damage remains unclear.

Purpose of the Study:

  • To investigate the association between BP load and target organ damage.
  • To determine if BP load is an independent predictor of target organ damage, beyond BP level.

Main Methods:

  • 869 individuals underwent 24-hour ABPM while off antihypertensive medication.
  • BP load was calculated as the percentage of elevated daytime/nighttime systolic/diastolic BP readings.
  • Measures of target organ damage included brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), left ventricular mass index (LVMI), and urinary albumin-to-creatinine ratio (ACR).

Main Results:

  • Higher systolic and diastolic BP load tertiles correlated with increased baPWV, cfPWV, LVMI, and ACR.
  • These associations lost statistical significance when adjusted for 24-hour BP levels.
  • In continuous analysis, BP load did not improve models predicting target organ damage, except for a negative association with cfPWV.

Conclusions:

  • Blood pressure load is associated with target organ damage.
  • This association is not independent of the overall blood pressure level.
  • BP level, rather than BP load, appears to be the primary determinant of target organ damage in this cohort.
Abstract

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