Publication Date:
2014-03-13
Description:
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 2 ; 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.
Keywords:
Clinical Studies
Print ISSN:
0194-911X
Topics:
Medicine