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Published on: May 3, 2018
Correlation between blood pressure variability and subclinical target organ damage in patients with essential
Mostafa El Mokadem1, Hesham Boshra2, Yasser Abd El Hady2
1Cardiology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt. mostafa.elmokadem9@gmail.com.
Insights
Blood pressure variability increases cardiovascular and renal damage risk. Average real variability (ARV) during ambulatory monitoring, not long-term measures, effectively predicts subclinical target organ damage in hypertension.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Research
Background:
- High blood pressure (BP) variability is linked to increased cardiovascular and renal damage, and mortality.
- Subclinical target organ damage (TOD) is a significant complication in patients with hypertension.
- Understanding BP variability's role in TOD is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the association between blood pressure variability and subclinical target organ damage (TOD) in patients with controlled essential hypertension.
- To compare the predictive value of long-term (visit-to-visit) and short-term (ambulatory) BP variability for TOD.
Main Methods:
- One hundred patients with controlled essential hypertension were assessed.
- Long-term BP variability was measured using standard deviation (SD) and coefficient of variance (CV) from office BP measurements.
- Short-term BP variability was evaluated using ambulatory BP monitoring (ABPM), calculating parameters like average real variability (ARV), SD, and CV.
- Subclinical TOD was assessed through various investigations.
Main Results:
- 73 out of 100 patients exhibited subclinical TOD.
- No significant differences in long-term BP variability parameters (SD, CV) were found between patients with and without TOD.
- Short-term variability, specifically average real variability (ARV), showed a consistent association with TOD.
- Daytime systolic ARV, nighttime diastolic ARV, and patient age were identified as independent predictors of TOD.
Conclusions:
- Average real variability (ARV) from ambulatory BP monitoring is a more effective index for assessing BP variability related to TOD than traditional long-term measures.
- ARV emerges as a valuable predictor of subclinical target organ damage in controlled essential hypertension.
- Further research may support ARV's clinical utility in managing hypertensive patients.
Abstract:
High blood pressure (BP) variability is associated with the increased risk of cardiovascular and renal damage together with increased cardiovascular mortality. The aim of our study was to investigate the relationship between BP variability and subclinical target organ damage (TOD) in patients with controlled essential hypertension. One hundred patients with controlled essential hypertension were randomly selected from outpatient clinic of Beni-Suef University hospital. All patients were subjected to full history taking, physical examination, three separate office BP measurements for assessment of long-term BP variability, ambulatory BP monitoring for short-term variability, and finally different investigations for subclinical TOD. We had 73 patients with subclinical TOD. Long-term visit-to-visit variability was evaluated by measuring SD (standard deviation) and CV (coefficient of variance) of systolic and diastolic BP. None of the parameters of long-term BP variability were significantly higher among patients with TOD compared with those without TOD. For short-term variability evaluated by ambulatory BP monitoring, average real variability (ARV) was the only parameter that had a significant consistent association with TOD in contrast to SD and CV. Finally, Daytime systolic ARV, nighttime diastolic ARV, and age were independent predictors of TOD (P values = 0.014, 0.018, 0.047, and 0.02, respectively). We concluded that ARV could be an appropriate index of BP variability and a more useful predictor of TOD in contrast to other parameters of BP variability.
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