Central blood pressure variability is increased in hypertensive patients with target organ damage

Area of Science:

• Cardiology
• Hypertension Research
• Vascular Biology

Background:

• Hypertension is a major risk factor for target organ damage (TOD).
• Short-term blood pressure variability (BPV) is increasingly recognized as a potential contributor to cardiovascular risk.
• Assessing BPV in both aortic and brachial arteries may offer insights into TOD development.

Purpose of the Study:

• To investigate the association between short-term BPV (aortic and brachial) and the presence of TOD in hypertensive patients.
• To compare the utility of aortic versus brachial BPV in identifying TOD.

Main Methods:

• 178 hypertensive patients (mean age 57 ± 12 years, 33% women) were studied.
• TOD was defined by left ventricular hypertrophy, microalbuminuria, reduced glomerular filtration rate, or increased aortic pulse wave velocity.
• 24-hour ambulatory blood pressure monitoring (Mobil-O-Graph) was used to assess aortic and brachial BPV and circadian patterns.

Main Results:

• 51.7% of patients had evidence of TOD.
• Patients with TOD exhibited increased night-to-day ratios for systolic and diastolic blood pressure and heart rate (aortic and brachial).
• Significantly elevated systolic BPV (standard deviations, coefficients of variation, average real variability) was observed in patients with TOD for both aortic and brachial measurements.

Conclusions:

• Short-term blood pressure variability is significantly increased in hypertensive patients with target organ damage.
• Aortic BPV measurements do not provide additional relevant information compared to brachial BPV for assessing TOD.
• BPV assessment, particularly brachial, is valuable in identifying hypertensive patients at risk for TOD.