Details

Autor(en) / Beteiligte

• Wei, Fang-Fei
• Li, Yan
• Zhang, Lu
• Xu, Ting-Yan
• Ding, Feng-Hua
• Wang, Ji-Guang
• Staessen, Jan A

Titel

Beat-to-Beat, Reading-to-Reading, and Day-to-Day Blood Pressure Variability in Relation to Organ Damage in Untreated Chinese

Ist Teil von

• Hypertension (Dallas, Tex. 1979), 2014-04, Vol.63 (4), p.790-796

Ort / Verlag

Hagerstown, MD: American Heart Association, Inc

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• Whether target organ damage is associated with blood pressure (BP) variability independent of level remains debated. We assessed these associations from 10-minute beat-to-beat, 24-hour ambulatory, and 7-day home BP recordings in 256 untreated subjects referred to a hypertension clinic. BP variability indices were variability independent of the mean, maximum–minimum difference, and average real variability. Effect sizes (standardized β) were computed using multivariable regression models. In beat-to-beat recordings, left ventricular mass index (n=128) was not (P≥0.18) associated with systolic BP but increased with all 3 systolic variability indices (+2.97–3.53 g/m; P<0.04); the urinary albumin-to-creatinine ratio increased (P≤0.03) with systolic BP (+1.14–1.17 mg/mmol) and maximum–minimum difference (+1.18 mg/mmol); and pulse wave velocity increased with systolic BP (+0.69 m/s; P<0.001). In 24-hour recordings, all 3 indices of organ damage increased (P<0.03) with systolic BP, whereas the associations with BP variability were nonsignificant (P≥0.15) except for increases in pulse wave velocity (P<0.05) with variability independent of the mean (+0.16 m/s) and maximum–minimum difference (+0.17 m/s). In home recordings, the urinary albumin-to-creatinine ratio (+1.27–1.30 mg/mmol) and pulse wave velocity (+0.36–0.40 m/s) increased (P<0.05) with systolic BP, whereas all associations of target organ damage with the variability indices were nonsignificant (P≥0.07). In conclusion, while accounting for BP level, associations of target organ damage with BP variability were readily detectable in beat-to-beat recordings, least noticeable in home recordings, with 24-hour ambulatory monitoring being informative only for pulse wave velocity.