Maximum home systolic blood pressure is a marker of carotid atherosclerosis
Toshiki Kaihara1,2, Satoshi Hoshide2, Naoko Tomitani2
1Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Insights
Maximum home systolic blood pressure (SBP) is a significant risk factor for hypertensive target organ damage. Measuring maximum SBP alongside mean SBP can improve risk assessment for cardiovascular complications.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Measurement
Background:
- Blood pressure (BP) variability is a recognized clinical parameter.
- Maximum home systolic blood pressure (SBP) has emerged as a key indicator of BP variability.
- The role of maximum SBP as a risk factor for hypertensive target organ damage (TOD) requires further investigation.
Purpose of the Study:
- To investigate the hypothesis that maximum home SBP is an independent risk factor for hypertensive target organ damage (TOD).
- To compare the association of maximum SBP with TOD markers against mean SBP.
Main Methods:
- A cross-sectional study involving 4,310 participants with at least one cardiovascular risk factor.
- Home BP was monitored for 14 consecutive days.
- Mean and maximum home SBP were analyzed as independent variables against TOD markers: left ventricular mass index (LVMI), brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (CIMT), and urine albumin creatinine ratio (UACR).
Main Results:
- Both mean and maximum home SBP were significantly associated with all assessed TOD markers.
- Maximum home SBP showed a statistically stronger association with carotid intima-media thickness (CIMT) compared to mean SBP (p<0.001).
Conclusions:
- Maximum home SBP is a clinically significant parameter in assessing hypertensive target organ damage.
- Routine measurement of maximum home SBP, in addition to mean home SBP, is recommended for comprehensive cardiovascular risk evaluation.
Abstract:
Background: Maximum home systolic blood pressure (maximum SBP) has been reported as a parameter of blood pressure (BP) variability. We tested the hypothesis that maximum SBP is one of the risk factors of hypertensive target organ damage (TOD).Methods: We conducted a cross-sectional study of 4,310 subjects with>1 cardiovascular risk factor. The subjects measured their home BP for 14 consecutive days. Mean and maximum SBPs were used as independent variables. As dependent variables, we used left ventricular mass index (LVMI), brachial-ankle pulse wave velocity (baPWV), maximum carotid intima-media thickness (CIMT), and urine albumin creatinine ratio (UACR).Results: In a multiple regression analysis, the subjects' mean and maximum SBPs were significantly associated with the above TOD markers. Compared to mean SBP, maximum SBP demonstrated a significantly stronger association with CIMT (p<0.001).Conclusion: Based on its clinical significance herein, measurement of maximum home SBP is warranted in addition to measurement of mean home SBP.
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