Association Between Circadian Hemodynamic Characteristics and Target Organ Damage in Patients With Essential Hypertension.
In: American journal of hypertension, Jg. 32 (2019-07-17), Heft 8, S. 742-751
academicJournal
Zugriff:
Background: This study investigated the association between circadian hemodynamic characteristics and asymptomatic hypertensive organ damage.
Methods: Circadian hemodynamics, including 24-hour brachial and aortic systolic blood pressure (SBP), pulse wave velocity (PWV), augmentation index (AIx@75), cardiac index, and total vascular resistance (TVR), were evaluated using an oscillometric device, Mobil-O-Graph, in 284 essential hypertensive patients (67.8 ± 16.0 years, 54% female). Hypertensive target organ damage (TOD), namely carotid wall thickening, left ventricular hypertrophy, and albuminuria, was assessed in all patients.
Results: Office SBP and 24-hour brachial and aortic SBP all increased with increasing number of organs involved (all P < 0.01 for trend). After multivariate logistic regression analysis, 24-hour brachial SBP (odds ratio [OR] = 1.04 for 1 mm Hg increase, P < 0.001) as well as aortic SBP (OR = 1.03 for 1 mm Hg increase, P < 0.05) maintained significance. Percent decrease during nighttime in brachial SBP, PWV, and TVR, but not cardiac index, showed a significant graded relationship with the number of organs involved. In a multivariate stepwise regression model, the nighttime values of brachial SBP, PWV, and TVR emerged as independent predictors of the presence of TOD.
Conclusion: In essential hypertension, 24-hour aortic SBP could be a marker of subclinical TOD, and further, the blunted nocturnal BP reduction in TOD patients might be mediated by disturbed circadian hemodynamic variations in aortic SBP, vascular resistance, and arterial stiffness.
(© American Journal of Hypertension, Ltd 2019. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Titel: |
Association Between Circadian Hemodynamic Characteristics and Target Organ Damage in Patients With Essential Hypertension.
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Autor/in / Beteiligte Person: | Kusunoki, H ; Iwashima, Y ; Kawano, Y ; Hayashi, SI ; Kishida, M ; Horio, T ; Shinmura, K ; Yoshihara, F |
Zeitschrift: | American journal of hypertension, Jg. 32 (2019-07-17), Heft 8, S. 742-751 |
Veröffentlichung: | 2013- : Oxford : Oxford University Press ; <i>Original Publication</i>: [New York, NY] : Elsevier, [c1988-, 2019 |
Medientyp: | academicJournal |
ISSN: | 1941-7225 (electronic) |
DOI: | 10.1093/ajh/hpz088 |
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